145例肝胆结石术后再次手术的原因分析及预防对策  

The Cause and Countermeasure of Operation for Hepatic Calculus Again

作　　者：曾鹏[1] 

机构地区：[1]彭州市人民医院普外科,四川成都611930

出　　处：《中国医药指南》2013年第18期434-435,共2页Guide of China Medicine

摘　　要：目的探究肝胆结石术后再次手术的原因分析及防治对策。方法随机选取并回顾分析2004年1月至2007年1月于我院肝胆结石术后再次进行手术患者145例,根据结石首发部位分为3组,其中肝内胆管结石96例(66.2%),胆总管结石31例(21.3%),胆囊结石患者18例(12.4%)。随访5年,对其术后并发症及5年内复发率进行统计。结果患者再次发病原因,肝胆结石再发患者109例(75.1%),胆总管囊肿和Caroli病26例(14.9%),胆肠吻合口狭窄10例(6.67%)。不同病因组患者总复发率不存在统计学差异(χ2=1.30,P>0.05)。结论首次手术前明确诊断和患者肝胆局部位置,制定完善正确的手术方案,术中注意操作防止医源性感染是预防减少手术是减少患者再次手术的主要手段。Objective To study the cause and countermeasure of operation for hepatic calculus again. Methods Choosed 145 patients of operation for hepatic calculus again from Jan. 2004 to Jan. 2007 to divide into 3 groups, and there were 96 cases of hepatolithiasis （66.2%）, and 31 cases choledocholithiasis （21.3%）, 31 cases of cholelithiasis （21.3%）. Followed up 5 years and study the rate of relapse. Results Studying the cause of operation for hepatic calculus again, there were 34 cases of hepatic calculi recurrence （75.55）, 26 cases of choledochocyst and Caroli disease （14.9%）, and 10 cases of bravery intestinal anastomosis stricture （6.67%）. And there was no significant difference between these three groups （P〈0.05）. Conclusion We should diagnose clearly and make surgical planning to prevent nosocomial infection.

关 键 词：肝胆结石 再次手术 防治 

分 类 号：R575.62[医药卫生—消化系统]