胆道T管引流术后并发症36例临床分析  

Management of postoperative complications in patients with biliary tract exploration and T-tube drainage

作　　者：金壮志[1] 赵登秋[1] 张喜成[1] 朱克明[1] 

机构地区：[1]淮安市楚州区城东卫生院外科,江苏省淮安223002

出　　处：《中国基层医药》2008年第1期34-35,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨胆道探查T管引流术后并发症发生的原因及其防治措施。方法对1986年至2002年间该院行972例胆道探查T管引流术后发生并发症的36例临床资料作回顾性分析。结果36例并发症中胆漏或胆汁性腹膜炎20例，胆道出血3例，胆道蛔虫症2例，T管压迫胃十二指肠致不全梗阻1例，T管拔断遗留胆总管内1例，术后胆汁引流量异常2例，术后黄疸急剧加深1例，并发急性胰腺炎2例，T管不能夹闭（胆道结石残留）3例，T管致胆道结石形成1例。本组保守治疗21例（58％），再手术治疗15例（42％）。除1例并发急性坏死性胰腺炎死亡，1例并发低渗性脱水、营养不良自动出院外，其余均痊愈出院。结论发生并发症的原因主要与手术操作技术、术后处理以及患者本身疾病、机体状况等有关。恰当的术中操作与术后处理是预防术后并发症发生的主要措施。Objective To study the causes and management of postoperative complications in patients with biliary tract exploration and T-tube drainage. Methods Clinical data of 36 patients who had undergone biliary tract exploration and T-tube drainage between 1986 and 2002 were studied retrospectively. Results Biliary fistula or bile peritonitis occurred in 20 cases, bile duct hemorrhage in 3 and ascariasis in 2, gastrocluodenal incomplete obstraction in 1, the remmants of T-tube in 1, abnormity of bile drainage quantity in 2 ,jaundice exacerbation in 1, acute pancreatitis in 2, T-tube could not be closed in 3 and lithogenesis in 1.21 （58 % ） patients underwent conservative therapy, 15 （42 % ） reoperation. Complications were cured in 34 cases. One who suffered from acute necrotic pancreatitis died, the other was voluntraily discharged from hsopital resulted from hypotonic dehydration and malnutrition. Conclusion Some complications were related to the operative handle and the expertise, others were related to the disease and patients＇ condition. Suitable operative handle, postoperative rational therapy and every measures improving the patients＇ general condition were important in preventing the complications.

关 键 词：胆总管造口术 手术后并发症 胆道T管引流术 原因分析 病例 防治 

分 类 号：R657.4[医药卫生—外科学]