摘要
目的分析总结影响急性结石性胆囊炎患者腹腔镜胆囊切除术中转开腹手术的相关临床因素。方法选取该院2017年1月-2018年5月择期采用腹腔镜胆囊切除术治疗的急性结石性胆囊炎患者64例,根据其是否中转开腹分为腹腔镜组(40例,顺利完成腹腔镜胆囊切除术)、中转开腹组(24例,中转开腹手术治疗),在术前对两组患者进行血常规检查、B超检查,比较两组患者在体温、胆囊壁厚、白细胞计数值、手术时机选择上的差异,探讨腹腔镜胆囊切除术中转开腹的影响因素。结果中转开腹组患者的术前体温≥38℃患者占79.2%、胆囊壁厚≥6 mm患者占70.8%、白细胞计数异常患者占62.5%、在发病后72 h接受手术患者占75.0%,均高于腹腔镜组,差异有统计学意义[术前体温(χ^2=4.205,P=0.040)、胆囊壁厚(χ^2=8.512,P=0.003)、白细胞计数(χ^2=13.371,P=0.000)和在手术时机选择(χ^2=16.600,P=0.000)](P<0.05)。结论在急性结石性胆囊炎腹腔镜胆囊切除手术中,患者的术前体温、胆囊壁厚度、白细胞计数、手术时机等,是其中转开腹手术的相关性影响因素。
Objective To analyze and summarize the clinical factors affecting laparoscopic cholecystectomy in patients with acute calculous cholecystitis. Methods Sixty-four patients with acute calculous cholecystitis treated with laparoscopic cholecystectomy were selected from January 2017 to May 2018 in the hospital. They were divided into laparoscopic group according to whether they were converted to open surgery(40 cases, successfully completed the abdominal cavity mirror cholecystectomy), open group(24 cases, conversion to open surgery), blood test and B-ultrasound were performed before operation, and the body temperature, gallbladder wall thickness and white blood cell count were compared between the two groups. The difference in value and timing of surgery was to explore the influencing factors of laparotomy during laparoscopic cholecystectomy. Results In patients with conversion to open surgery, the preoperative body temperature was ≥38°C, 79.2%, gallbladder wall thickness ≥6 mm, 70.8%, white blood cell count abnormality,62.5%, and 75.0% after surgery, higher than the laparoscopic group, the difference was statistically significant [preoperative body temperature(χ^2=4.205, P=0.040), gallbladder wall thickness(χ^2=8.512, P=0.003), white blood cell count(χ^2=13.371, P=0.000) and timing of surgery was selected(χ^2=16.600, P=0.000)](P<0.05). Conclusion In patients with acute calculous cholecystitis undergoing laparoscopic cholecystectomy, the patient’s preoperative body temperature,gallbladder wall thickness, white blood cell count, and timing of surgery are the relevant factors influencing the conversion to open surgery.
作者
宋明
SONG Ming(Department of Surgery,Integrated Traditional Chinese and Western Medicine Hospital,Yandu District,Yancheng,Jiangsu Province,224021 China)
出处
《系统医学》
2019年第20期86-88,共3页
Systems Medicine
关键词
急性结实性胆囊炎
腹腔镜胆囊切除术
中转开腹
影响因素
Acute solid cholecystitis
Laparoscopic cholecystectomy
Conversion to open surgery
Influencing factors
