高原地区和非高原地区腹腔镜胆囊切除术的比较  

Comparison of Laparoscopic Cholecystectomy between the Highland and Non-highland Area

作　　者：黄韬[1] 罗彪[1] 刘佳[1] 杜景平[1] 

机构地区：[1]四川大学华西医院西藏成办分院普外一科,成都610041

出　　处：《华西医学》2011年第10期1514-1516,共3页West China Medical Journal

摘　　要：目的探讨高原地区腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者的特点,以便更好地进行围手术期处理。方法对2009年2月2010年5月收治的长期生活在西藏高原地区的患者(高原组)367例和非高原地区患者(非高原地区组)167例的一般资料、术前诊断、合并症情况进行回顾性分析,两组患者性别、年龄及病程比较,差异无统计学意义(P>0.05),有可比性。两组患者诊断均以胆囊结石为主,其次为胆囊息肉,诊断构成比较,差异无统计学意义(P>0.05);两组患者合并症比较,高原组患者高血压、冠心病、血红蛋白增多症及窦性心动过缓的发生率高于非高原地区组(P<0.05);肺部疾病、肝硬化、糖尿病及脑梗死的发生率两组患者比较差异无统计学意义(P>0.05)。两组患者均采用常规LC进行治疗,对两组患者术后临床结果、并发症等进行统计学分析。结果高原组患者手术中转开腹率(7.1%)高于非高原地区组(2.4%)患者(P<0.05);高原组患者较非高原地区组患者住院时间长、手术时间长、术中出血量多(P<0.05);术后并发症比较差异无统计学意义(P>0.05)。结论高原地区LC患者宜及时中转开腹,其围手术期处理得当将有助于减少术后并发症的发生。Objective To explore the characteristics of patients undergoing laparoscopic cholecystcctomy in highland area, in order to carry out better perioperative management. Methods We collected and analyzed the general information, preoperative diagnosis and complications of 367 patients living in highland area and 167 patients living m inland between February 2009 and May 2010. There was no significant difference between the two groups in sex, age and course of disease （P~〉0. 05）. Cholecystolithiasis was the main disease followed by gallbladder polyps, and there was no difference between them in the kind of diseases （P〉0. 05）. The incidence of hypertension, coronary heart disease, hereditary persistence of fetal hemoglobin and sinus bradycardia was higher in patients in highland area than that in patients in nowhighland area （P^0. 05）. There was no significant difference in the incidence of hmg disease, liver cirrhosis, diabetes mellitus and cerebral infarction between the two groups （P〉O. 05）. Conventional laparoscopic cholecystectomy was conducted in both two groups. Comparative analysis of treatment outcome and postoperative complications was done. Results The rate of conversion from laparoscopic surgery to laparotomy in Tibetan patients （7. 1 %） was higher than that in patients in non-highland area （2.4%） （P〈0. 05）. Hospitalization time, operation time and blood loss in Tibetan patients were significantly higher than those in patients in non-highland area （P〈 0.05）, but there was no significant difference in postoperative complications between the two groups of patients （P〉0. 05）. Conclusions I.aparoscopic cholecystectomy for patients in highlardarea should be converted to laparotomy when necessary. Appropriate perioperative management is helpful in reducing the incidence of postoperative complications.

关 键 词：腹腔镜胆囊切除术 并发症 高原地区患者 

分 类 号：R657.4[医药卫生—外科学] R575.6[医药卫生—临床医学]