腹腔镜胃转流术治疗2型糖尿病围手术期呼吸系统风险因素分析  

The analysis of risk factors to perioperative respiratory system for laparoscopic gastric bypass surgery in the treatment of type 2 diabetes mellitus

作　　者：牟琳[1] 高巍[1] 王勇[1] 

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《腹腔镜外科杂志》2013年第1期12-14,共3页Journal of Laparoscopic Surgery

基　　金：国家自然科学基金资助(编号:81000158)

摘　　要：目的:探讨腹腔镜胃转流手术围手术期肺部并发症发生的风险因素及处理方法。方法:回顾分析2009～2010年为30例患者行胃转流手术的临床资料,其中男11例,女19例;2型糖尿病患者比例为43%,糖尿病前期比例为21%。通过患者风险暴露程度分为高、中、低三组,分别为9例、12例、9例。通过评估风险暴露程度与术后肺部并发症严重程度间的关系,探讨腹腔镜胃转流手术后肺部并发症的风险相关因素及处理方法。结果:30例均顺利完成手术。高风险组肺部并发症发生率明显高于低风险组,差异有统计学意义。风险因素分析中,术中反流造成严重肺部并发症的几率为40%,明显高于其他原因,差异有统计学意义。结论:术前呼吸系统风险评估对于预防术后肺部并发症具有重要意义,术前针对呼吸系统疾病进行处理对于降低术后并发症的发生风险具有重要意义。Objective：To investigate the risk factors to respiratory system during perioperative period of laparoscopic gastric bypass surgery and their treatment method.Methods：From Jan.2009 to Jan.2010 the clinical data of 30 patients underwent laparoscopic gastric bypass surgery were retrospectively analyzed to evaluate the relations between risk factors and postoperative respiratory complications.There were 11 male patients and 19 female patients.43% of the patients were type 2 diabetes mellitus,and 21% were prediabetes.According to the degree of exposurg to risk,the patients were divided into 3 groups：high（n=9）,middle（n=12） and low（n=9） risk group.Results：All the operations were performed successfully.The incidence of respiratory complications in high risk group were significantly higher than that in low risk group.Reflux was the most common risk factor to induce pulmonary complications,its odds was 40%.Conclusions：Preoperative evaluation and management of risk factors is significantly important to prevent and reduce postoperative respiratory complications.

关 键 词：糖尿病 2型 胃转流术 腹腔镜检查 呼吸系统 

分 类 号：R656.61[医药卫生—外科学]