摘要
目的:探讨急性坏痘性胆囊炎患者术中胆管损伤的危险因素,并提出预防及处理建议。方法:对2019年1月-2021年12月安徽医科大学附属六安医院收治的实施手术的100例急性坏痘性胆囊炎患者的临床资料进行回顾,根据术中胆管损伤情况分为发生组和未发生组。总结可能影响此类患者术中胆管损伤的危险因素,分别进行单因素和多因素logistic回归分析,并根据分析结果提出预防及处理建议。结果:该组病例中共有12例发生胆道损伤,发生率为12.00%;发生组性别、年龄>60岁、伴有高血压和伴有高脂血症者构成比与未发生组对比均差异无统计学意义(P>0.05),发生组发病至人院时间>6h、伴有糖尿病、胆囊穿孔、腹膜炎、经腹腔镜手术、伴有胆道结石、胆囊管解变异、术者工龄3年者构成比均高于未发生组,差异均有统计学意义(P 0.05),且经logistic回归分析均证实为急性坏痘性胆囊炎患者术中胆管损伤的独立危险因素(OR=2.744、7.068、8.986.8.412、3.912、3.8773.826、10.875、4.132,P<0.05)。结论:急性坏痘性胆囊炎患者术中胆管损伤的发生率高,且发病至人院时间>6h、伴有糖尿病等均为其发生的独立危险因素,应当加强防控,及时处理,以改善预后。
Objective:To explore the risk factors of bile duct injury in patients with acute gangrenous cholecystitis during operation and suggest prevention and treatment.Methods:The clinical data of 100 patients with acute gangrenous cholecystitis treated in Lu'an Hospital of Anhui Medical University from January 2019 to December 2021 were reviewed.The bile duct injuries were divided into occurrence and non-occurrence groups according to the bile duct injury during operation.This paper summarized the risk factors that may affect the postoperative bile duct injury in such patients and carried out a single factor and multiple factor logistictic.regression analysis respectively,and proposed prevention and treatment recommendations according to the analysis results.Results:There were 12 cases of biliary tract injury in this group;the incidence was 12.00%.There was no significant difference in the rates of sex,age>60,hypertension and hyperlipidemia between the two groups(P>O.05).The rates of onset to admission time>6 h,accompanied by diabetes,gallbladder perforation,peritonitis,laparoscopic surgery,cholelithiasis,cystic duct anatomy and variation,and the operation age of the 3 years in the occurrence group were all higher than those in the non occurrence group,between which the differences were statistically significant(P<0.05),and they were the independent risk factors for postoperative bile duct injury in patients with acute gangrenous cholecystitis confirmed by logistic regression analysis(OR=2.744,7.068,8.986,8.412,3.912,3.877,3.826,10.875,4.132,P<O.05).Conclusion:The incidence of bile duct injury in patients with acute gangrenous cholecystitis is high,onset to admission time>6 h,accompanied by diabetes,are independent risk factors.Prevention and control should be strengthened to improve the prognosis.
作者
金俊红
项建斌
李永宏
孙华健
黄辉
JIN Junhong;XIANG Jianbin;LI Yonghong;SUN Huajian;HUANG Hui(Department of Hepatobiliary Surgery,Luan Hospital Affiliated to Anhui Medical University,Luan,Anhui,237105,China)
出处
《中国中西医结合消化杂志》
CAS
2022年第7期518-522,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
急性坏痘性胆囊炎
胆管损伤
危险因素
处理
acute gangrenous cholecystitis
bile duct injury
risk factors
treatment
