摘要
目的回顾性对比观察聚乳酸防粘连凝胶对术后意外胆瘘的影响,以确定其使用的适应症和相对禁忌症。方法采用回顾性对比的方法,选取我院2012年10月-2014年10月,未使用防粘连剂6122例与2014年11月-2016年11月,使用防粘剂6096例胆石症患者分为对照组与观察组,均施行腹腔镜胆囊切除、胆总管探查手术,术后各发生意外胆瘘27例与26例。观察术后胆瘘出现的时间、体温恢复正常所需时间、引流液量、引流管留置时间、住院时间。结果聚乳酸防粘连凝胶组在术后差异有统计学意义(P<0.05)。结论聚乳酸防粘连凝胶对腹部手术后预防肠粘连有明显作用,但明显延长了术后胆瘘的痊愈时间,对术中情况复杂,预计术后有可能出现胆瘘者,不应使用防粘连凝胶,建议设为使用防粘连凝胶的相对禁忌症。
Objective To compare the effects of polylactic acid anti adhesion gel on postoperative biliary fistula after operation and to identify indications and relative contraindications.Methods A retrospective comparison was made between 6122 cases of patients with cholelithiasis who did not use anti-adhesion agent from October 2012 to October 2014 and 6096 cases of patients with cholelithiasis who used anti-adhesion agent from November 2014 to November 2016 in our hospital.They were divided into the control group and the observation group,Laparoscopic cholecystectomy and common bile duct exploration were performed in two groups and there were 27 cases and 26 cases of accidental biliary fistula in corresponding group.The time of biliary fistula after operation,the time required for the body temperature to return to normal,the amount of drainage fluid,the indwelling time of drainage tube,and the length of hospital stay were observed.Results Compared with the no-use polylactic acid gel group,the difference of polylactic acid gel group was statistically significant(P<0.05).Conclusion Polylactic acid anti-adhesion gel has an obvious effect on preventing intestinal adhesion after abdominal surgery,but it can obviously prolong the recovery time of postoperative biliary fistula.For patients with complicated intraoperative conditions and possible postoperative biliary fistula,anti-adhesion gel should not be used.It is recommended to set it as a relative contra to the use of anti-adhesion gel.
作者
张佳
冯晶
ZHANG Jia;FENG Jing(Nursing Department,986 Hospital of Air Force of PLA,Xi’an 710054’China)
出处
《肝胆外科杂志》
2021年第3期211-213,共3页
Journal of Hepatobiliary Surgery
关键词
术后意外胆瘘
聚乳酸防粘连凝胶
预防
postoperative accidental biliary fistula
polylactic acid gel
prevent
