摘要
目的探究腹腔镜下胆囊切除术(LC)后发生上腹痛的原因及危险因素,为临床预防和诊治提供参考。方法回顾2018年1月至2020年1月在龙岩市第二医院行LC的312例患者的临床资料,分析术后发生上腹痛的原因,并采用Logistic回归分析方法探寻术后发生上腹痛的危险因素。结果312例患者行LC后,有29例发生上腹痛;单因素分析结果显示,发生上腹痛患者合并慢性胃病、残留胆囊管或胆总管小结石、手术时间≥1 h、胆囊与周围组织粘连、术前病程≥1周占比与未发生上腹痛患者比较,差异均有统计学意义(P<0.05);进一步进行多因素非条件Logistic回归分析,结果显示,合并慢性胃病、残留胆囊管或胆总管小结石、手术时间≥1 h、胆囊与周围组织粘连、术前病程≥1周均为LC后发生上腹痛的独立危险因素(P<0.05)。结论对合并慢性胃病、残留胆囊管或胆总管小结石、手术时间长、胆囊与周围组织粘连严重、术前病程长等导致LC后发生上腹痛的危险因素进行针对性预防和诊治,对改善患者预后具有重要的意义。
Objective The causes and risk factors of postoperative epigastric pain after laparoscopic cholecystectomy(LC)were investigated to provide references for clinical prevention and treatment.Methods The clinical data of 312 cases who underwent LC in The Second Hospital of Longyan from January 2018 to January 2020 were reviewed to analyze the causes of postoperative epigastric pain and the risk factors of postoperative epigastric pain were explored by Logistic regression analysis method.Results Among the 312 cases,29 cases suffered epigastric pain;The univariate analysis results showed that when the proportions of chronic gastric disease,small calculi of cystic duct or common bile duct remaining,operation time≥1 h,adhesion to surrounding tissues,and preoperative course≥1 week of epigastric pain patients and those without epigastric pain were compared,the differences were statistically significant(P<0.05).Then the multi-factor Logistic regression analysis results showed that chronic gastric disease,small calculi of cystic duct or common bile duct remaining,operation time≥1 h,adhesion to surrounding tissues,and preoperative course≥1 week were all the risk factors of epigastric pain after LC(P<0.05).Conclusion Targeted intervention and treatment for the risk factors of chronic gastric disease,small calculi of cystic duct or common bile duct remaining,long operation time,serious adhesion to surrounding tissues,and long preoperative course are beneficial to improve the prognosis of patients.
作者
陈小鹏
修喆
陈煌祥
曾文龙
Chen Xiaopeng;Xiu Zhe;Chen Huangxiang;Zeng Wenlong(Department of Genneral Surgery,The Second Hospital of Longyan,Longyan Fujian 364000,China)
出处
《医疗装备》
2021年第22期8-9,共2页
Medical Equipment
关键词
腹腔镜下胆囊切除术
术后上腹痛
危险因素
Laparoscopic cholecystectomy
Postoperative epigastric pain
Risk factors
