摘要
目的探讨腹腔镜胆囊切除术(LC)术后是否放置腹腔引流对治疗急性化脓性胆囊炎(ASC)和急性坏疽性胆囊炎(AGC)的影响。方法2012年10月到2021年10月于我院行LC的ASC和AGC患者160例,根据术中是否放置腹腔引流分为引流管组和无引流管组各80例,比较两组患者的手术时间、术后肩部疼痛、伤口疼痛(24 h内)、术后下床活动时间、术后肛门排气时间、术后出血、胆漏、腹腔感染、肺部感染、伤口感染和下肢深静脉血栓(DVT)的发生率。结果两组患者无术后出血、伤口感染及腹腔感染。引流管组切口疼痛率高于无引流管组,术后下床活动时间、肛门排气时间及术后住院时间长于无引流管组,差异有统计学意义(P<0.05)。肩部疼痛、肺部感染、DVT及术后胆漏发生情况比较,差异无统计学意义(P>0.05)。结论ASC和AGC患者行LC放置引流管可能出现更多的并发症,术后恢复时间及住院时间更长,对于术中腹腔无明显污染,胆囊动脉及胆囊颈管处理妥当的患者可不放置引流管。
Objective To investigate the value of laparoscopic cholecystectomy(LC)without abdominal drainage in the treatment of acute suppurative cholecystitis(ASC)and acute gangrenous cholecystitis(AGC).Methods Clinical data of 160 patients with ASC and AGC who underwent LC in our hospital from October 2012 to October 2021 were analyzed retrospectively.According to whether abdominal drainage was placed during operation,they were divided into a drainage group and a non-drainage group,80 in each group.The operation time,postoperative shoulder pain,wound pain within 24 hours,postoperative ambulation time,postoperative anal exhaust time,postoperative bleeding,bile leakage,abdominal infection,lung infection,wound infection,and deep venous thrombosis(DVT)were compared between the two groups.Results There was no postoperative bleeding,wound infection and abdominal infection in the two groups.The incision pain rate was higher,and the postoperative ambulation time,anal exhaust time and postoperative hospital stay were longer in the drainage group than those in the non-drainage group(P<0.05).There was no significant difference in shoulder pain,pulmonary infection,DVT and postoperative bile leakage(P>0.05).Conclusion LC drainage tube placement in ASC and AGC patients may cause more complications.The postoperative recovery time and hospital stay are longer.For patients without obvious contamination of the abdominal cavity during the operation,and the cystic artery and cystocervical canal are properly handled,the drainage tube may not be placed.
作者
何贤禄
HE Xian-lu(Department of Hepatobiliary Pancreatic and Vascular Surgery, The Second Affiliated Hospital of Chengdu Medical College/Nuclear Industry 416 Hospital, Chengdu 610051, China)
出处
《实用医院临床杂志》
2022年第3期85-88,共4页
Practical Journal of Clinical Medicine
