腹腔镜联合多视频清创技术在复杂感染性胰腺坏死中的应用  

Laparoscopic combined with multi-video debridement in treatment of complicated infectious pancreatic necrosis

作　　者：高崇崇[1] 李非[1] 曹锋[1] 王晓辉[1] 李昂[1] 王喆[1] 张超[1] 蒋哲 Gao Chongchong;Li Fei;Cao Feng;Wang Xiaohui;Li Ang;Wang Zhe;Zhang Chao;Jiang Zhe(Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院普外科,北京100053

出　　处：《中华肝胆外科杂志》2021年第5期354-357,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：首都临床特色应用研究与成果推广(Z171100001017077);首都卫生发展科研专项(2020-1-2012);首都医科大学临床医学高精尖学科建设项目(1192070312)。

摘　　要：目的探讨腹腔镜联合多视频清创技术在复杂感染性胰腺坏死(CIPN)中的应用效果。方法回顾性分析2017年8月至2019年12月首都医科大学宣武医院普外科治疗的34例CIPN患者临床资料,根据视频处理方式将患者分为腹腔镜+术中超声组、腹腔镜+胆道镜组、单纯腹腔镜组。对三组患者的手术次数、手术时间、出血量、术后并发症发生率、病死率、总住院时间等指标进行统计分析和比较。结果腹腔镜+术中超声组共有患者13例,年龄(56.4±13.4)岁;腹腔镜+胆道镜组7例,年龄(48.0±8.4)岁;单纯腹腔镜组14例,年龄(51.4±15.6)岁。腹腔镜+术中超声组、腹腔镜+胆道镜组及单纯腹腔镜组的手术次数分别为(2.2±1.1)次、(1.6±0.8)次、(2.9±1.4)次,其中腹腔镜+胆道镜组的手术次数小于单纯腹腔镜组,差异有统计学意义(P<0.05)。腹腔镜+术中超声组、腹腔镜+胆道镜组及单纯腹腔镜组的手术时间分别为(70.5±22.9)min、(65.7±19.9)min、(51.5±15.4)min,腹腔镜+术中超声组的手术时间长于单纯腹腔镜组,差异有统计学意义(P<0.05)。三组在出血量、术后并发症发生率、病死率、总住院时间方面差异均无统计学意义(均P>0.05)。结论腹腔镜联合多视频清创技术可充分发挥各视频方式的优点,对改善CIPN患者疗效具有重要参考意义。Objective To study the clinical application of laparoscopic combined with multi-video debridement in treatment of complicated infectious pancreatic necrosis(CIPN).Methods The clinical data of 34 patients with CIPN who were treated at the Department of General Surgery,Xuanwu Hospital,Capital Medical University from August 2017 to December 2019 were retrospectively studied.Based on the different video methods used,these patients were divided into 3 groups:the laparoscopic combined with intraoperative ultrasound group,the laparoscopic combined with choledochoscopy group and the laparoscopic group.The number of operations,operation time,blood loss,postoperative complication rates,mortality rates and total length of hospital stay were compared.Results There were 13 patients in the laparoscopic combined with intraoperative ultrasound group,with age of(56.4±13.4)years.There were 7 patients in the laparoscopic combined with choledochoscopy group,with age of(48.0±8.4)years.There were 14 patients in the laparoscopic group with age of(51.4±15.6)years.The number of operations of the laparoscopic combined with intraoperative ultrasound group,the laparoscopic combined with choledochoscopy group and the laparoscopic group were(2.2±1.1),(1.6±0.8),(2.9±1.4),respectively.The number of operations of the laparoscopic combined with choledochoscopy group were significantly less than that of the laparoscopic group(P<0.05),but there were no significant differences among the other groups(P>0.05).The operation time of the laparoscopic combined with intraoperative ultrasound group,the laparoscopic combined with choledochoscopy group and the laparoscopic group were(70.5±22.9)min,(65.7±19.9)min,(51.5±15.4)min,respectively.The operation time of the laparoscopic combined with intraoperative ultrasound group was significantly longer than that of the laparoscopic group(P<0.05),but there were no significant differences among the other groups(P>0.05).There were no differences in blood loss,postoperative complication rate,mortality rates a

关 键 词：胰腺 腹腔镜检查 复杂感染性胰腺坏死 联合多视频 

分 类 号：R657.5[医药卫生—外科学]