摘要
目的研究急性胆囊炎(AC)患者腹腔镜胆囊切除术(LC)后并发胆管损伤(BDI)的危险因素。方法选择2017年3月~2018年7月在青海省交通医院(以下简称“我院”)接受LC术治疗后并发BDI的AC患者58例记为观察组,另选同期在我院接受LC术治疗后未并发BDI的AC患者50例记为对照组。两组均常规给予LC术式治疗,分析LC术后并发BDI与患者性别和年龄等资料的关系,应用Logistic回归分析法评价LC术后并发BDI的危险因素。比较两组除BDI外的并发症情况。结果观察组患者胆囊壁的厚度>4 mm、胆囊三角解剖存在变异,以及医师经验<30例的比例均分别较对照组明显更高(P<0.05)。按照Logistic回归分析法进行数据处理后发现,LC术后并发BDI的危险因素有胆囊壁的厚度>4 mm、胆囊三角解剖存在变异,以及医师经验<30例(P<0.05)。两组除BDI外的并发症总发生率比较,差异无统计学意义(P>0.05)。结论 AC患者接受LC术治疗后并发BDI的危险因素有胆囊壁的厚度>4 mm、胆囊三角解剖存在变异,以及医师经验<30例,临床上应针对上述因素进行积极干预,从而有助于提升患者的手术安全性。
Objective To study the risk factors of bile duct injury (BDI) after laparoscopic cholecystectomy (LC) in patients with acute cholecystitis (AC). Methods Fifty-eight cases of AC patients with BDI after LC treatment in Qinghai Traffic Hospital (“our hospital” for short) from March 2017 to July 2018 were selected as observation group, and 50 cases of AC patients who were not complicated with BDI after LC in our hospital were selected as the control group. Both groups were routinely treated with LC. The relationship between BDI after LC and sex, age of patients was analyzed. The risk factor of BDI after LC was evaluated by Logistic regression analysis. Complications of the two groups were compared except for BDI. Results The the proportion of thickness of gallbladder wall >4 mm, the anatomy of gallbladder triangle had variation, and the physician experience <30 cases in the observation group was significantly higher than the control group (P<0.05). According to the results of Logistic regression analysis, the thickness of the gallbladder wall >4 mm, the anatomy of gallbladder triangle had variation, and the physician experience <30 cases were the risk factors for BDI after LC (P<0.05). There was no significant difference in the total incidence of complications besides BDI between the two groups (P > 0.05). Conclusion The risk factors of BDI in patients with AC after LC include the thickness of gallbladder wall >4 mm, the anatomy of gallbladder triangle has variation, and the physician experience <30 cases. Clinical intervention should be directed against the above factors, which will help to improve the safety of patients.
作者
林建寿
陈荣吉
赵思娟
马英
LIN Jianshou;CHEN Rongji;ZHAO Sijuan;MA Ying(The First Department of General Surgery, Qinghai Traffic Hospital, Qinghai Province, Xining 810001,China;the Second Department of General Surgery, Qinghai Traffic Hospital, Qinghai Province, Xining 810001, China;Department of Anesthesiology, Qinghai Traffic Hospital, Qinghai Province, Xining 810001, China)
出处
《中国医药导报》
CAS
2019年第13期99-102,共4页
China Medical Herald
基金
青海省医药卫生科技项目(2015-wjdx-58)
关键词
急性胆囊炎
腹腔镜胆囊切除术
胆管损伤
危险因素
Acute cholecystitis
Laparoscopic cholecystectomy
Bile duct injury
Risk factor
