中国现代药物应用
中國現代藥物應用
중국현대약물응용
CHINESE JOURNAL OF MODERN DRUG APPLICATION
2015年
15期
5-7
,共3页
胆囊炎%胆囊结石%腹腔镜胆囊切除术%中转开腹%原因%时机
膽囊炎%膽囊結石%腹腔鏡膽囊切除術%中轉開腹%原因%時機
담낭염%담낭결석%복강경담낭절제술%중전개복%원인%시궤
Cholecystitis%Gallbladder stone%Laparoscopic cholecystectomy%Alternative laparotomy%Cause%Opportunity
目的：探讨胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术(LC)中转开腹的原因及时机。方法回顾性分析83例胆囊炎合并胆囊结石患者临床病历资料,根据其实际手术情况分成成功完成腹腔镜胆囊切除术组(A组, n=30)、主动中转开腹组(B组, n=26)和被动中转开腹组(C组, n=27)三组。分析三组患者中转开腹危险因素对比差异,记录其术程、术中出血量、术后排气时间、住院时间等指标。结果①B、C两组在白细胞计数、胆囊壁厚度及上腹部手术史等危险因素对比上明显高于A组,比较差异有统计学意义(P<0.05)；②治疗后, A组术程、术中出血量、术后排气时间及住院时间为三组中最短,其次为B组,C组患者术程、术后排气时间及住院时间最长,术中出血量最高,对比差异均具有统计学意义(P<0.05)。结论导致胆囊炎合并胆囊结石患者在腹腔镜胆囊切除术中临时中转开腹手术的危险因素分别为胆囊壁厚度、腹部手术史及白细胞计数等,根据术中探查情况主动中转开腹手术更利于提高患者预后质量。
目的：探討膽囊炎閤併膽囊結石患者行腹腔鏡膽囊切除術(LC)中轉開腹的原因及時機。方法迴顧性分析83例膽囊炎閤併膽囊結石患者臨床病歷資料,根據其實際手術情況分成成功完成腹腔鏡膽囊切除術組(A組, n=30)、主動中轉開腹組(B組, n=26)和被動中轉開腹組(C組, n=27)三組。分析三組患者中轉開腹危險因素對比差異,記錄其術程、術中齣血量、術後排氣時間、住院時間等指標。結果①B、C兩組在白細胞計數、膽囊壁厚度及上腹部手術史等危險因素對比上明顯高于A組,比較差異有統計學意義(P<0.05)；②治療後, A組術程、術中齣血量、術後排氣時間及住院時間為三組中最短,其次為B組,C組患者術程、術後排氣時間及住院時間最長,術中齣血量最高,對比差異均具有統計學意義(P<0.05)。結論導緻膽囊炎閤併膽囊結石患者在腹腔鏡膽囊切除術中臨時中轉開腹手術的危險因素分彆為膽囊壁厚度、腹部手術史及白細胞計數等,根據術中探查情況主動中轉開腹手術更利于提高患者預後質量。
목적：탐토담낭염합병담낭결석환자행복강경담낭절제술(LC)중전개복적원인급시궤。방법회고성분석83례담낭염합병담낭결석환자림상병력자료,근거기실제수술정황분성성공완성복강경담낭절제술조(A조, n=30)、주동중전개복조(B조, n=26)화피동중전개복조(C조, n=27)삼조。분석삼조환자중전개복위험인소대비차이,기록기술정、술중출혈량、술후배기시간、주원시간등지표。결과①B、C량조재백세포계수、담낭벽후도급상복부수술사등위험인소대비상명현고우A조,비교차이유통계학의의(P<0.05)；②치료후, A조술정、술중출혈량、술후배기시간급주원시간위삼조중최단,기차위B조,C조환자술정、술후배기시간급주원시간최장,술중출혈량최고,대비차이균구유통계학의의(P<0.05)。결론도치담낭염합병담낭결석환자재복강경담낭절제술중림시중전개복수술적위험인소분별위담낭벽후도、복부수술사급백세포계수등,근거술중탐사정황주동중전개복수술경리우제고환자예후질량。
Objective To investigate cause and opportunity of alternative laparotomy in laparoscopic cholecystectomy(LC) for cholecystitis complicated with gallbladder stone patients. Methods Clinical data of 83 cholecystitis complicated with gallbladder stone patients were retrospectively analyzed. The patients were divided by surgery condition into laparoscopic cholecystectomy group (group A, n=30), active alternative laparotomy group (group B, n=26), and passive alternative laparotomy group (group C, n=27). Differences of risk factors for alternative laparotomy were compared in the three groups, and their operation process, intraoperative bleeding volume, postoperative exhaust time, and hospital stay were recorded. Results ①Groups B and C had much higher white blood cell count, thickness of gallbladder wall, and history of epigastrium operation than the group A. Their difference had statistical significance (P<0.05). ②After treatment, group A had the shortest operation process, intraoperative bleeding volume, postoperative exhaust time, and hospital stay among the three groups. Those were in middle levels in group B, and those of group C were the longest ones. Their differences had statistical significance (P<0.05). Conclusion Thickness of gallbladder wall, history of epigastrium operation, and white blood cell count are the risk factors of alternative laparotomy in laparoscopic cholecystectomy for cholecystitis complicated with gallbladder stone patients. Active alternative laparotomy according to intraoperative probing status is helpful for improving prognosis quality of patients.
