中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
16期
24-25
,共2页
损伤性胆管狭窄%手术时机%手术效果
損傷性膽管狹窄%手術時機%手術效果
손상성담관협착%수술시궤%수술효과
Traumatic biliary stricture%Operation opportunity%Operative effect
目的：回顾性分析损伤性胆管狭窄患者手术时机对手术效果的影响。方法回顾性分析安阳市人民医院损伤性胆管狭窄患者90例，根据手术时间将上述患者分为 A 组（损伤3个月内手术）、B 组（损伤3个月后手术），对上述患者采取间置胆管十二指肠吻合术、肝门部胆管整形胆管空肠γ型吻合术、带蒂组织瓣修复术，比较两组患者不同手术时机、手术方式的临床效果，并观察并发症危险因素。结果 A 组治愈率（91.84%）高于 B 组（75.61%），差异有统计学意义（P ﹤0.05）；三种术式治疗优率分别为70.00%、76.47%、66.67%，差异未见统计学意义（P ﹥0.05）；共25例患者出现严重并发症，包括广泛渗血6例，顽固性腹水4例，切口裂开感染5例，肝功能不全9例，肺炎并胸腔积液1例，并发症组年龄、血清胆红素、黄疸时间较非并发症组显著较高（P ﹤0.05），血清白蛋白水平则显著较低（P ﹤0.05）。结论损伤性胆管狭窄患者建议早期行胆道修复手术，但具体设定仍需结合患者实际情况，若患者具备手术条件，则应尽早行胆管修复重建术。
目的：迴顧性分析損傷性膽管狹窄患者手術時機對手術效果的影響。方法迴顧性分析安暘市人民醫院損傷性膽管狹窄患者90例，根據手術時間將上述患者分為 A 組（損傷3箇月內手術）、B 組（損傷3箇月後手術），對上述患者採取間置膽管十二指腸吻閤術、肝門部膽管整形膽管空腸γ型吻閤術、帶蒂組織瓣脩複術，比較兩組患者不同手術時機、手術方式的臨床效果，併觀察併髮癥危險因素。結果 A 組治愈率（91.84%）高于 B 組（75.61%），差異有統計學意義（P ﹤0.05）；三種術式治療優率分彆為70.00%、76.47%、66.67%，差異未見統計學意義（P ﹥0.05）；共25例患者齣現嚴重併髮癥，包括廣汎滲血6例，頑固性腹水4例，切口裂開感染5例，肝功能不全9例，肺炎併胸腔積液1例，併髮癥組年齡、血清膽紅素、黃疸時間較非併髮癥組顯著較高（P ﹤0.05），血清白蛋白水平則顯著較低（P ﹤0.05）。結論損傷性膽管狹窄患者建議早期行膽道脩複手術，但具體設定仍需結閤患者實際情況，若患者具備手術條件，則應儘早行膽管脩複重建術。
목적：회고성분석손상성담관협착환자수술시궤대수술효과적영향。방법회고성분석안양시인민의원손상성담관협착환자90례，근거수술시간장상술환자분위 A 조（손상3개월내수술）、B 조（손상3개월후수술），대상술환자채취간치담관십이지장문합술、간문부담관정형담관공장γ형문합술、대체조직판수복술，비교량조환자불동수술시궤、수술방식적림상효과，병관찰병발증위험인소。결과 A 조치유솔（91.84%）고우 B 조（75.61%），차이유통계학의의（P ﹤0.05）；삼충술식치료우솔분별위70.00%、76.47%、66.67%，차이미견통계학의의（P ﹥0.05）；공25례환자출현엄중병발증，포괄엄범삼혈6례，완고성복수4례，절구렬개감염5례，간공능불전9례，폐염병흉강적액1례，병발증조년령、혈청담홍소、황달시간교비병발증조현저교고（P ﹤0.05），혈청백단백수평칙현저교저（P ﹤0.05）。결론손상성담관협착환자건의조기행담도수복수술，단구체설정잉수결합환자실제정황，약환자구비수술조건，칙응진조행담관수복중건술。
Objective To retrospectively analyze the influence of operation timing on operation effect of patients with traumatic bile duct stricture. Methods Retrospective analyzed the 90 patients with biliary stricture injury in Anyang People’s hospital,according to the operation time,the patients were divided into group A(damage inside March surgery) and group B(damage in March after surgery). All patients took interposition choledochoduodenostomy,hilar bile duct airγ type plastic intestinal anastomosis,pedicle flap reconstruction. The clinical effects of patients with different timing of op-eration,operative methods were compared,and the risk factors of complications were observed. Results The cure rate in group A(91. 84% )was higher than that in group B(75. 61% ),the difference was significant(P ﹤ 0. 05);excellent rates of three surgical treatment were 70% ,76. 47% ,66. 67% ,there was no significant difference(P ﹥ 0. 05);a total of 25 patients with serious complications,including extensive bleeding in 6 patients,4 patients with intractable ascites,5 ca-ses of wound dehiscence and infection,liver dysfunction in 9 cases,pneumonia and pleural effusion in 1 case,complica-tions age,serum bilirubin and jaundice time was significantly higher than non complication group(P ﹤ 0. 05),serum albu-min levels were significantly lower(P ﹤ 0. 05). Conclusions Early Biliary stenosis of biliary tract surgery are suggested in patients,but the specific setting still need to combined with actual situation,if it has surgical conditions,so should be as early as possible taken bile duct reconstruction.
