腹腔镜术后氧气置换对于胆总管结石患者术后厌氧菌感染的影响  

Effects of postoperative oxygen displacement on postoperative anaerobic bacteria infection after laparoscopic surgery

作　　者：李连博[1] 尹思能[2] 田刚[2] 肖宏[2] 孙科[2] 谢雨芹 

机构地区：[1]遵义医学院第一临床学院,贵州遵义503003 [2]四川省成都市第二人民医院肝胆胰外科,四川成都610017

出　　处：《中国内镜杂志》2015年第10期1016-1018,共3页China Journal of Endoscopy

摘　　要：目的为了解腹腔镜术后腹腔内局部高氧环境对于胆总管结石患者术后厌氧菌感染的影响情况,为临床合理选择腹腔镜术后处理方式提供依据。方法选取2014年1月-2014年12月到该院就诊的胆囊结石伴胆总管结石并且术中胆汁培养显示厌氧菌阳性患者共30例随机分为两组,对照组采用腹腔镜胆囊切除术、胆总管探查术、胆总管切开取石术和胆总管I期缝合术,术后不予以氧气置换出患者腹腔内的二氧化碳。实验组采用腹腔镜胆囊切除术、胆总管探查术、胆总管切开取石术和胆总管I期缝合术,术后予以氧气两次置换出患者腹腔内的二氧化碳,使患者腹腔内保持高浓度氧气状态结束手术。对两种手术方案的术后白细胞计数、中性粒细胞百分比及降钙素原(PCT)进行观察。结果两种方式相对比下,术后白细胞计数、中性粒细胞百分比及PCT的下降结果显示差异有统计学意义(P<0.05),实验组的术后感染指标:中性粒细胞百分比及PCT,均低于对照组。结论腹腔镜胆囊切除术、胆总管探查术、胆总管切开取石术和胆总管I期缝合术,术后予以氧气置换出患者腹腔内的二氧化碳,可使术后细菌感染相关的实验室检测指标明显减少,此方法值得临床推广。【Objective】To understand the influence of intraperitoneal local high oxygen environment for anaerobic bacteria infection postoperatively in patients with common bile duct calculi, provide the basis for clinical rational selection of laparoscopic surgery.【Methods】 30 anaerobic bacteria infection patients from January 2014 to December 2014 were randomly divided into two groups, control group using laparoscopic gallbladder excision, common bile duct exploration, laparoscopy choledochotomy, suture choledoch immediately, without oxygen replacement with carbon dioxide in abdominal cavity, the experimental group using laparoscopic gallbladder excision, common bile duct exploration, laparoscopy choledochotomy, suture choledoch immediately, after surgery while with oxygen replacement in patients with intra-abdominal carbon dioxide, keep the abdominal cavity with high concentration of oxygen in the end of operation. And then observe the white blood cell count, neutrophil percentage and calcitonin.【Results】White blood cell count, neutrophil percentage and calcitonin reduced in the original results show that the difference was statistically significant（P〈0.05）, postoperative infection of experimental indexes, neutrophil percentage and calci-tonin, are lower than the control group. 【Conclusion】Laparoscopic gallbladder excision, common bile duct exploration, laparoscopy choledochotomy, suture choledoch immediately, after surgery uesing oxygen replacement out patients with intra-abdominal carbon dioxide can make the laboratory tests of postoperative bacterial infection related index decreased significantly, this method is worthy of clinical promotion.

关 键 词：腹腔镜 氧气 厌氧菌 胆总管结石 

分 类 号：R575.7[医药卫生—消化系统]