腹腔镜胆道探查术后发生肺栓塞的相关因素分析  

Study on the related factors of pulmonary embolism after laparoscopic biliary tract exploration

作　　者：王万鹏 季春勇 罗红杰 WANG Wan-peng;JI Chun-yong;LUO Hong-jie(Department of Hepatic-biliary-pancreatic Minimally Invasive Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州中心医院肝胆胰微创外科,河南郑州450007

出　　处：《腹腔镜外科杂志》2020年第4期281-284,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜胆道探查术后发生肺栓塞(PE)的危险因素。方法:选取2012年12月至2018年12月行腹腔镜胆道探查术的163例患者作为研究对象,并根据肺动脉造影CT检查结果分为PE组与非PE组。比较两组患者临床资料及围手术期资料。采用多因素logistic分析筛选出术后发生PE的危险因素。结果:163例患者术后20例发生PE,总发生率为12.3%。呼吸困难(65.0%)、咳嗽(60.0%)、发热(50.0%)是常见的临床表现。PE组年龄≥65岁、糖尿病史、冠心病史、脑梗死史、术前休克、手术时间≥240 min、术后卧床时间≥3 d的比例高于非PE组,体质指数(BMI)≥20 kg/m2的比例低于非PE组,差异有统计学意义(P<0.05)。结论:腹腔镜胆道探查术后PE的发生与患者疾病史、年龄、术后卧床时间等多种因素有关。其中年龄≥65岁、糖尿病史、脑梗死史、手术时间≥240 min是术后PE发生的独立危险因素。Objective:To discuss the risk factors of pulmonary embolism(PE)after laparoscopic biliary tract exploration.Methods:All of 163 patients who underwent laparoscopic biliary tract exploration from Dec.2012 to Dec.2018 were selected as research objects.According to the results of pulmonary artery angiography CT examination,the patients were divided into PE group and non-PE group.The baseline data and perioperative data of the two groups were compared.Multivariate logistic analysis was used to screen out the risk factors of PE after operation.Results:Twenty cases of PE were found in all 163 patients,the total incidence was 12.3%.Dyspnea(65.0%),cough(60.0%),fever(50.0%)were common clinical manifestations.In PE group,the patients with age≥65,history of diabetes,history of coronary heart disease,history of cerebral infarction,preoperative shock,the operation time≥240 min and postoperative bedridden time≥3 d were significantly more than those in the non-PE group,the patients of BMI≥20 kg/m2 were significantly less than those in the non-PE group,with significantly statistical difference(P<0.05).Conclusions:The occurrence of PE after laparoscopic biliary tract exploration is related to patients'disease history,age,postoperative bedridden time and other factors.Among them,the age≥65,history of diabetes,history of cerebral infarction and the operation time≥240 min are independent risk factors for PE after operation.

关 键 词：胆道探查术 腹腔镜检查 肺栓塞 危险因素 

分 类 号：R657.4[医药卫生—外科学]