摘要
目的分析胆囊结石伴胆囊炎患者临床行腹腔镜胆囊切除术(LC)最佳时机,以及患者术中中转开腹的影响因素分析。方法选取2015年1月～2018年1月期间来我院行腹腔镜胆囊切除术手术治疗的80例胆囊结石伴胆囊炎患者为本次观察对象,收集患者病历资料并按手术时机分为1组(48h内手术)、2组(48h～2周内)、3组(2周后择期手术),观察三组患者手术情况(术中失血量、手术耗时、引流量、中转开腹率),同时以Logistic回归分析患者中转开腹影响因素,及独立危险因素。结果患者中转开腹与手术时机、结石嵌顿、胆囊壁厚、白细胞计数有关,P <0.05;手术时机、结石嵌顿、白细胞计数为患者中转开腹的独立影响因素;组间比较术中出血量、引流量、手术耗时有差异,且2组较其他组引流量、失血量多手术耗时长,P <0.05。结论临床对胆囊结石、胆囊炎患者行LC术最佳手术时机为发病后48h,手术时机、结石嵌顿、白细胞计数为中转开腹影响因素。
Objective To analyze the best time of laparoscopic cholecystectomy(LC)and factors influencing the choice of conversion to open surgery for cholecystolithiasis with cholecystitis patients.Methods Eighty cholecystolithiasis with cholecystitis patients who underwent laparoscopic cholecystectomy in our hospital from January2015to January2018were selected,their clinical data were collected and divided into groups according to the operative timing,Group1(surgery within48hours),Group2(surgery within48h-2weeks)and Group3(selection of operative time after2weeks).The operation conditions of the three groups were observed(intraoperative blood loss,operation time,drainage,conversion to open surgery rate).Logistic regression was used to analyze the influencing factors of conversion to open surgery and its independent risk factors.Results The choice of conversion to open surgery was associated with timing of operation,stone incarceration,gallbladder wall thickness and white blood cell count(P<0.05).Operative timing,stone incarceration and white blood cell count were independent influencing factors for conversion to open surgery.There were differences in intraoperative blood loss,drainage volume and operation time between groups,drainage volume and intraoperative blood loss of Group2were more than the other two groups,and operation time was longest(P<0.05).Conclusion The best time of LC operation for patients with cholecystolithiasis and cholecystitis is48hours after onset.Operating time,stone incarceration and white blood cell count are the influencing factors for conversion to open surgery.
作者
黄火成
吴登东
刘秀媚
HUANG Huocheng;WU Dengdong;LIU Xiumei(General Surgery, Zhaoqing No.2 People’s Hospital, Zhaoqing 526000, China;Emergency Department, ZhaoqingNo.2 People’s Hospital, Zhaoqing 526000, China)
出处
《中国医药科学》
2018年第21期192-194,198,共4页
China Medicine And Pharmacy
关键词
中转开腹
胆囊切除术
结石嵌顿
白细胞计数
Conversion to open surgery
Cholecystectomy
Stone incarceration
White blood cell count
