摘要
目的探讨腹腔镜胆囊切除术(LC)并发症发生的常见原因及其防治措施。方法回顾性分析2002年1月—2012年1月在我院行LC的1 860例病人的临床资料,采用χ2检验和Logistic回归方法对可能导致LC并发症发生的9个临床因素进行分析。结果病人年龄、性别、结石数量、手术方式与LC并发症的发生率没有相关性(P>0.05),而术前血浆清蛋白水平、胆囊三角的解剖、胆囊萎缩、胆囊壁厚度以及术者的经验5个因素与LC并发症的发生率有关(χ2=4.664～18.552,P<0.05)。Logistic回归分析显示,胆囊三角的解剖结构不清、胆囊壁厚度、术者的经验对LC手术并发症发生有影响(OR=1.440～3.064,P<0.05)。结论严格的术前检查有助于明确诊断,提高手术的安全性;术中规范的手术操作程序可预防并发症的发生;并发症一旦发生,应尽早处理,确保病人的生命安全。
Objective To investigate the complications of laparoseopie eholecystectomy （LC） and management. Me- thods Clinical data of 1 860 patients who underwent LC in our hospital （during 2002.01--2012.01） were reviewed retrospectively. Nine clinical factors that possibly lead to the complications of LC were analyzed by employing x2 test and Logistic regression. Re- sults Patient age, sex, calculus quantity, and mode of surgery were not associated with the complications （P〉0.05）, and the fol- lowing five factors-preoperative plasma albumin level, anatomy of eystohepatic triangle, gallbladder atrophy, thickness of gallblad- der wall and doctor＇s experience-were correlated with the complications （Z 2 = 4. 664--18. 552, P 〈0.05 ）. Logistic regression analy- sis showed that unclear anatomic structure of cystohepatie triangle, the thickness of gallbladder wall, and experience of the surgeon were associated with the complications of LC （OR=1.440--3.064,P〈0.05）. Conclusion A strict preoperative inspection helps identified diagnosis and raises the safety of surgery; a normative operative procedure can prevent the complications; once complica- tions occur, management should be carried out as early as possible to save a patient＇s life.
出处
《齐鲁医学杂志》
2013年第3期266-268,共3页
Medical Journal of Qilu
