摘要
目的分析胆结石患者腹腔镜胆囊手术中转开腹的并发症及影响因素。方法对2015年1月至2017年12月我院收治的230例胆结石患者的临床资料进行回顾分析,探讨腹腔镜胆囊手术中转开腹的并发症及影响因素,从而采取相应的防范措施。结果 230例患者中,有17例患者中转开腹手术(7.39%)。OC组患者的并发症总发生率为52.94%,高于LC组患者的14.55%,差异有统计学意义(P<0.05)。OC组有上腹部手术史、胆囊炎发作>5次者占比均大于LC组,胆囊壁厚度大于LC组、白蛋白水平低于LC组,白细胞计数多于LC组,差异具有统计学意义(P<0.05)。结论对胆结石患者,应该在行腹腔镜胆囊切除术前综合考虑中转开腹手术的影响因素,并作风险评估,做好术前难度预测,适时中转开腹手术,从而最大程度地降低患者的术后并发症,提高治疗效果。
Objective To investigate the complications and influence factors of conversion from laparoscopic cholecystectomy to open cholecystectomy in patients with cholelithiasis. Methods From January 2015 to December 2017,the clinical data of 230 patients with cholelithiasis in our hospital were retrospectively analyzed. The complications and influence factors of conversion from laparoscopic cholecystectomy to open cholecystectomy were investigated to take corresponding preventive measures. Results Of the 230 patients, 17 cases were converted to open cholecystectomy（7.39%）. The total incidence of complications in the OC group was 52.94%, which was higher than 14.55% in the LC group, the difference was statistically significant（P 0.05）. The proportions of patients with upper abdominal surgery history, cholecystitis episodes 5 times in the OC group were greater than those in the LC group, the gallbladder wall thickness was greater than that of the LC group, the level of albumin was lower than that of the LC group, the white blood cell count was more than that of the LC group（P0.05）. Conclusion For patients with gallstones, the factors influencing the conversion to open cholecystectomy should be considered before laparoscopic cholecystectomy, and the risk assessment should be made to predict the preoperative difficulty, convert to the open cholecystectomy when necessary, so as to minimize postoperative complications and improve treatment outcomes.
作者
史甲平
SHI Jia-ping(Gastroenterology Department,Hancheng People＇s Hospital,Hancheng 715415,China)
出处
《临床医学研究与实践》
2018年第23期57-58,共2页
Clinical Research and Practice
