腹腔镜胆囊切除术转开腹的危险因素分析  

Analysis of the risk factors for conversion from laparoscopic to laparotomy

作　　者：詹建兴 申海军[1] 

机构地区：[1]西安航天总医院肝胆外科,陕西西安710100

出　　处：《西部医学》2012年第10期1871-1872,共2页Medical Journal of West China

基　　金：陕西省卫生厅科研基金课题(No:2010036124)

摘　　要：目的探讨腹腔镜胆囊切除术转开腹的主要危险因素。方法回顾分析住院接受腹腔镜胆囊切除术患者1200例临床资料,其中中转开腹112例患者作为观察组,选取同期手术成功120例患者作为对照组。采用χ2检验和Logistic回归对腹腔镜胆囊切除术中转开腹的主要危险因素进行分析。结果胆囊壁厚度(≥0.4cm)、胆囊炎发作到手术时间(≥72h)、胆囊三角的清晰度、血清总胆红素(≥17μmol/L)、胆囊结石嵌顿以及墨菲氏征阳性均为胆囊切除术中转开腹的危险因素。结论正确认识腹腔镜胆囊切除术的危险因素对降低手术中转开腹具有重要意义。Objective To explore the risk factors of conversion from laparoscopic to open cholecystectomy.Methods 1200 patients underwent laparoscopic were analyzed for the risk factors for conversion rates.112 patients with laparotomy were selected as observe group.120 patients successfully performing Laparoscopic cholecystectomy were selected as control group.Risk factors for conversion from laparoscopic to laparotomy were analyzed by Chi square test and multivariate logistic analysis.Results Multivariate analysis showed that the risk factors were as follows： thickened wall o f gallbladder（≥0.4 cm）,cholecystitis attack（≥72h）,definition of cystohepatic triangle,high level of total bilirubin（≥17μmol/L）,gallbladder stone disease,and Murphy sign.Conclusion Preoperative comprehensive evaluation of risk factor can reduce the rate of conversion from laparoscopic to laparotomy.

关 键 词：腹腔镜胆囊切除术 中转开腹 危险因素 

分 类 号：R657.4[医药卫生—外科学]