医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2015年
16期
119-120
,共2页
肝胆手术%胆瘘%临床分析
肝膽手術%膽瘺%臨床分析
간담수술%담루%림상분석
Liver and gallbladder surgery%Biliary fistula%Clinical analysis
目的：研究分析肝胆手术并发胆瘘的治疗方法和治疗效果。方法：选取我院2013年5月至2014年6月收治的22例肝胆手术后并发胆瘘的患者，对患者的临床治疗进行回顾性分析，观察患者的治疗方式和治疗效果。结果：所有22例患者中，接受非手术引流治疗的有17例，其余5例因胆管严重损伤接受再次手术治疗，均住院期间全部治愈，治愈率达到100％。通过对所有患者进行造影检查，其中有16例患者可以明确胆瘘的位置和原因，治愈的时间不同，其中8例在3周之内治愈，占36.4%。在3-4周之内治愈的有5例，占22.7%。在4周之后治疗的有4例，占18.2%。对患者出院之后进行随访，随访的时间为6-12个月，患者均未出现其他并发症。结论：针对肝胆手术后并发胆瘘的患者需要对其进行临床分析，胆瘘的发生不仅和患者自身的病因有关，还与手术操作过程有关。对于胆瘘患者，临床应做好充分引流这一预防工作，肝胆手术结束后尽早进行诊断，并对患者发生胆瘘的具体原因、漏出量，以及腹膜炎程度等进行认真观察，从而选择适宜的治疗方式。
目的：研究分析肝膽手術併髮膽瘺的治療方法和治療效果。方法：選取我院2013年5月至2014年6月收治的22例肝膽手術後併髮膽瘺的患者，對患者的臨床治療進行迴顧性分析，觀察患者的治療方式和治療效果。結果：所有22例患者中，接受非手術引流治療的有17例，其餘5例因膽管嚴重損傷接受再次手術治療，均住院期間全部治愈，治愈率達到100％。通過對所有患者進行造影檢查，其中有16例患者可以明確膽瘺的位置和原因，治愈的時間不同，其中8例在3週之內治愈，佔36.4%。在3-4週之內治愈的有5例，佔22.7%。在4週之後治療的有4例，佔18.2%。對患者齣院之後進行隨訪，隨訪的時間為6-12箇月，患者均未齣現其他併髮癥。結論：針對肝膽手術後併髮膽瘺的患者需要對其進行臨床分析，膽瘺的髮生不僅和患者自身的病因有關，還與手術操作過程有關。對于膽瘺患者，臨床應做好充分引流這一預防工作，肝膽手術結束後儘早進行診斷，併對患者髮生膽瘺的具體原因、漏齣量，以及腹膜炎程度等進行認真觀察，從而選擇適宜的治療方式。
목적：연구분석간담수술병발담루적치료방법화치료효과。방법：선취아원2013년5월지2014년6월수치적22례간담수술후병발담루적환자，대환자적림상치료진행회고성분석，관찰환자적치료방식화치료효과。결과：소유22례환자중，접수비수술인류치료적유17례，기여5례인담관엄중손상접수재차수술치료，균주원기간전부치유，치유솔체도100％。통과대소유환자진행조영검사，기중유16례환자가이명학담루적위치화원인，치유적시간불동，기중8례재3주지내치유，점36.4%。재3-4주지내치유적유5례，점22.7%。재4주지후치료적유4례，점18.2%。대환자출원지후진행수방，수방적시간위6-12개월，환자균미출현기타병발증。결론：침대간담수술후병발담루적환자수요대기진행림상분석，담루적발생불부화환자자신적병인유관，환여수술조작과정유관。대우담루환자，림상응주호충분인류저일예방공작，간담수술결속후진조진행진단，병대환자발생담루적구체원인、루출량，이급복막염정도등진행인진관찰，종이선택괄의적치료방식。
Objective The analysis of the treatment of liver and gallbladder surgery complicated with biliary fistula and therapeutic effect.Methods Selected from May 2013 to June 2014 were 22 cases of liver patients complicated with biliary fistula after the surgery, the clinical treatment of patients were retrospectively analyzed, the treatment and treatment effect were observed.Results Of all 22 cases, drainage of non-surgical therapy in 17 cases, the remaining 5 patients for bile duct injury serious surgery again, are all hospital cure, cure rate is 100%.By imaging examination of all patients, including 16 patients can clear position and reasons of biliary fistula, cure time, of which 8 cases cured within 3 weeks, accounting for 36.4%.In three to four weeks to heal in 5 cases, accounting for 22.7%.Within 4 weeks after treatment of 4 cases, accounting for 18.2%.To follow-up of patients after hospital discharge, the follow-up time was 6 to 12 months, no other complications occurred.Conclusion In view of the liver and gallbladder surgery patients need to be complicated with biliary fistula after clinical analysis, the occurrence of biliary fistula is not only related to the causes of the patient's own, also related to the operation process.For patients with biliary fistula, clinical should be well drainage of the prevention work, after the liver and gallbladder surgery diagnosis as soon as possible, and to the specific reason for the patients with biliary fistula, leakage amount, and degree of peritonitis careful observation, so as to choose the suitable treatment.
