摘要
目的:探讨胆道T管引流术后,拔除T管的最佳时间。方法:选取135例胆总管探查患者,将其随机分成腹腔镜组和开腹组,其中腹腔镜组和开腹组又分别随机分成术中使用普通T管组和双腔T管(专利号:ZL201520158397.7)组,术后2周起每周均行上腹CT检查,观察T管窦道壁的厚度,双腔T管组加做T管窦道造影,观察T管窦道形成的完整性。记录不同时间段T管窦道壁的厚度和T管窦道形成的完整与否,进行拔除T管,从而得出临床上最为适宜的T管拔除时间。结果:T管窦道完整形成后,窦道壁厚度小于4 mm时,拔除T管胆漏的发生率明显高于在窦道壁厚度大于4 mm时拔除T管胆漏的发生率,χ2=4.446,P=0.035,差异有统计学意义。结论:利用双腔T管联合腹部CT检查可以为临床适宜时间安全拔除T管提供客观依据。术后行T管窦道造影显示窦道形成完整,上腹CT显示T管窦道壁厚度大于4 mm,此时即为最佳的临床拔除T管时间。
Objective To investigate the best time of removal of T tube after biliary drainage of T tube. Method 135 cases of common bile duct exploration patients were selected and randomly divided into laparoscopic group and laparotomy group. Laparoscopic group and laparotomy group were separately divided into operation using common T tube group and double lumen T tube（ patent number： ZL 201520158397. 7） group at random. Two weeks after the operation,patients were underwent abdominal CT examination weekly to observe the thickness of the T tube sinus wall,double lumen T tube group was added with T tube sinus radiography to observe the integrity of the T tube sinus formation. The patients were recorded the thickness of the T tube sinus wall and observed T tube sinus formed completely or not at different time,then they were removed the T tube,and concluded the most suitable T tube removal time clinically. Results After the complete formation of the T tube sinus tract,when the thickness of the sinus wall was less than 4 mm,the incidence of bile leak after removal of T tube was significantly higher than that which was greater than 4 mm,there were significant differences（ χ2= 4. 446,P = 0. 035）. Conclusion The use of double lumen T tube combined with abdominal CT examination can provide the objective basis for the safe extraction of T tube in clinical time. Postoperative T tube sinus angiography shows sinus formed completely and abdominal CT shows the thickness of the T tube sinus wall which is greater than 4 mm,then it is the optimal clinical time to remove the T tube.
出处
《吉林医学》
CAS
2017年第1期54-58,共5页
Jilin Medical Journal
关键词
T管
窦道
CT
拔管
时间
T tube
Sinus
CT
Extubation
Time
