CAJ | 학술논문

目的探讨胆囊结石合并糖尿病患者手术方法和时机的选择.方法 2002年4月至2008年9月102例胆囊结石合并糖尿病的患者采用前瞻性对照方法比较分析急诊和择期行腹腔镜胆囊切除术(观察组53例)和开腹胆囊切除术(对照组49例)手术时间、术中出血量、胆囊破裂、胆道损伤、心律失常等情况及术后切口感染、肺部感染、泌尿系感染、住院时间等情况.结果对照组手术时间和出血量均高于观察组(P<0.05),组内急诊手术时间和出血量均高于择期手术(P<0.05);观察组胆囊破裂发生率均明显高于对照组(P<0.05),且组内急诊手术发生率高于择期手术(P<0.05),对照组组内无显著差异(P>0.05);观察组心功能不全发生率显著高于对照组(P<0.05),组内比较急诊手术发生率显著高于择期手术(P<0.05),对照组组内无显著差异(P>0.05).对照组切口感染发生率显著高于观察组(P<0.05),两组组内急诊手术患者发生率均高于择期手术患者(P>0.05);对照组患者住院时间明显长于观察组患者(P<0.05).结论糖尿病患者无症状胆囊结石或在出现症状后尽早积极治疗的同时安排择期手术;手术方式的选择需综合考虑患者病情.
목적 탐토담낭결석합병당뇨병환자수술방법 화시궤적선택.방법 2002년4월지2008년9월102례담낭결석합병당뇨병적환자채용전첨성대조방법 비교분석급진화택기행복강경담낭절제술(관찰조53례)화개복담낭절제술(대조조49례)수술시간、술중출혈량、담낭파렬、담도손상、심률실상등정황급술후절구감염、폐부감염、비뇨계감염、주원시간등정황.결과 대조조수술시간화출혈량균고우관찰조(P<0.05),조내급진수술시간화출혈량균고우택기수술(P<0.05);관찰조담낭파렬발생솔균명현고우대조조(P<0.05),차조내급진수술발생솔고우택기수술(P<0.05),대조조조내무현저차이(P>0.05);관찰조심공능불전발생솔현저고우대조조(P<0.05),조내비교급진수술발생솔현저고우택기수술(P<0.05),대조조조내무현저차이(P>0.05).대조조절구감염발생솔현저고우관찰조(P<0.05),량조조내급진수술환자발생솔균고우택기수술환자(P>0.05);대조조환자주원시간명현장우관찰조환자(P<0.05).결론 당뇨병환자무증상담낭결석혹재출현증상후진조적겁치료적동시안배택기수술;수술방식적선택수종합고필환자병정.
Objective To investigate the alternative and effective of surgical treatment on patients with cholecystolithiasis and diabetes mellitus.Methods 102 patients with diabetes mellitus were observed.53 as experimental group were performed laparoscopic cholecystectomy,and 49 were performed open cholecystectony as control group.The condition in operation and after operation were compared between the two groups.Results The duration of operation andthe amount of haemorrhage were significantly higher in the control group than in the experimental group(P<0.05),in operation the incidence of gallbladder rupture and cardia insufficiency in the experimental group were significantly than the control group(P<0.05).the incidence of infection of incisional wound were significantly higher in the control group than in the experimental group(P<0.05),and the length of stay were longer(P<0.05).Conclusion Patients with cholecystolithiasis and diabetes mellitus should run the selective operation as soon as possible,but modus operandi depends.