CAJ | 학술논문

目的探讨影响胆囊切除术中胆管损伤的危险因素，总结应对措施。方法随机选取2009年12月到2012年11月行胆囊切除术的4300例临床病例作为调查对象，对其中25例胆管损伤进行危险因素分析。结果术中无胆管造影、胆囊三角解剖异常、手术经验欠缺是胆囊切除术中胆管损伤的危险因素。性别、年龄、既往史、血总胆红素浓度、胆囊壁厚度、胆总管直径、临床分期等差异无统计学意义（P＞0．05）；采用Logistic单因素和多因素进行危险因素分析，胆囊三角解剖结构、手术经验是胆囊切除术中胆管损伤的独立危险因素（ P＝0．032和0．041）。结论在胆囊切除术中，要尽可能考虑到胆管损伤的危险因素，避免损伤胆管，以便降低患者痛苦，提高临床效果。
목적탐토영향담낭절제술중담관손상적위험인소，총결응대조시。방법수궤선취2009년12월도2012년11월행담낭절제술적4300례림상병례작위조사대상，대기중25례담관손상진행위험인소분석。결과술중무담관조영、담낭삼각해부이상、수술경험흠결시담낭절제술중담관손상적위험인소。성별、년령、기왕사、혈총담홍소농도、담낭벽후도、담총관직경、림상분기등차이무통계학의의（P＞0．05）；채용Logistic단인소화다인소진행위험인소분석，담낭삼각해부결구、수술경험시담낭절제술중담관손상적독립위험인소（ P＝0．032화0．041）。결론재담낭절제술중，요진가능고필도담관손상적위험인소，피면손상담관，이편강저환자통고，제고림상효과。
Objective To study the effect of cholecystectomy bile duct injury risk factors ,summarizes the countermeasures .Methods Randomly selected from December 2009 to November 2012 in our hospital line cholecys-tectomy of 4 300 cases of clinical cases as research object ,the 25 cases of bile duct injury in dangerous factor analysis . Results No bile duct intraoperative imaging ,gallbladder triangle anatomical anomalies ,surgery is lack of experience in cholecystectomy bile duct injury risk factors .More than sex .Age ,previous medical history ,blood total bilirubin concentration ,gallbladder wall thickness ,common bile duct diameter ,clinical stage are no significant difference ,P>0 .05 ,no statistical significance ;The Logistic single factor and multiple factors analysis of risk factors ,from the fol-lowing form that cystic triangle anatomy ,surgical experience is cholecystectomy bile duct injury in the independent risk factors(P=0 .032 and 0 .041) .Conclusion In cholecystectomy ,must as far as possible considering the bile duct injury risk factors ,to avoid to damage the bile duct ,if there are bile duct injury ,the early decision to take reasonable remedial measures ,in order to reduce patients pain ,improve the clinical effect .