CAJ | 학술논문

目的:研究HIV感染者胆囊结石的手术风险因素和围手术期处理.方法:对20例HIV感染者胆囊结石手术前进行常规检查,用流式细胞仪检测T淋巴细胞亚群,CD4 T淋巴细胞<200 cell/μl者,给予口服SMZ和氟康唑预防肺孢子虫肺炎和真菌感染,对血友病患者围手术期应用凝血Ⅷ因子.结果:20例患者均在全麻下行胆囊切除手术,5例术后发生脓毒症,无手术死亡.发生脓毒症组的术前CD4 T淋巴细胞绝对值、CD4/CD8比值、血色素及术后CD4 T淋巴细胞绝对值、血色素、血清白蛋白水平均明显低于无脓毒症组.结论:对HIV感染合并胆囊结石行胆囊切除有较高的脓毒症发病率,适当的围手术期处理可以取得较好的疗效.
목적:연구HIV감염자담낭결석적수술풍험인소화위수술기처리.방법:대20례HIV감염자담낭결석수술전진행상규검사,용류식세포의검측T림파세포아군,CD4 T림파세포<200 cell/μl자,급여구복SMZ화불강서예방폐포자충폐염화진균감염,대혈우병환자위수술기응용응혈Ⅷ인자.결과:20례환자균재전마하행담낭절제수술,5례술후발생농독증,무수술사망.발생농독증조적술전CD4 T림파세포절대치、CD4/CD8비치、혈색소급술후CD4 T림파세포절대치、혈색소、혈청백단백수평균명현저우무농독증조.결론:대HIV감염합병담낭결석행담낭절제유교고적농독증발병솔,괄당적위수술기처리가이취득교호적료효.
Objective:To study the surgical risk factors and the perioperative management of cholecystectomy in the HIV infected patients with gallbladder stones. Method:Preoperative routine examination was done for all 20 HIV-infected patients with gallbladder stones and flow cytometry instrument was used to test T-lymphocyte subsets. Sulfamethoxazole and fluconazole were administered only to the patients with CD4<200 cells/μl. for preventing pneumocystis carinii pneumonia and fungal infections. Coagulation factorⅧwas given to the patient with hemophilia. Result:Cholecystectomy was performed on 20 cases under general anesthesia. Five cases occurred with postoperative sepsis, but no mortality. Abnormal results of preoperative tests including CD4、CD4/CD8、hemoglobin and those of postoperative tests including CD4、hemoglobin、albumin were the risk factors of sepsis in HIV-infected patients. Conclusion:The HIV-infected patients are more likely to develop postoperative sepsis. Appropriate management and rational use of antibiotics could help reducing the rate of postoperative infection.