基层医院胆囊切除患者临床分析  

作　　者：占小朋 蓝伟峰[1] 王启斌[1] 

机构地区：[1]浙江省遂昌县人民医院,323399

出　　处：《浙江临床医学》2022年第7期999-1000,共2页Zhejiang Clinical Medical Journal

摘　　要：目的分析县级基层医院行胆囊切除手术患者的临床特点及诊治情况.方法2017年1月至2021年4月遂昌县人民医院因胆囊炎、胆囊结石、胆囊息肉行胆囊切除术的患者571例.分析其病因、手术情况及术后恢复情况.结果571例患者中,男265例,女306例.平诊就诊480例,急诊就诊91例.既往有胆绞痛发作症状235例,有胆囊炎发作123例,无明显症状213例.腹腔镜下完成手术562例,中转剖腹手术9例,其中急诊7例,平诊2例.急诊手术患者手术时间、术中出血、术后并发症、住院时间及住院费用与平诊患者比较,差异有统计学意义(P<0.05).平诊患者中,手术前6周内有胆绞痛发作史者102例,有胆囊炎发作史者25例,无症状者353例.与无症状患者相比,6周内有胆绞痛及胆囊炎发作的患者,手术时间明显延长,差异有统计学意义(P<0.05).结论在基层医院,行胆囊切除的患者中,急性胆囊炎及反复发作的胆囊炎患者比例较高.近期有急性胆囊炎发作的患者,会增加手术难度,但行腹腔镜下胆囊切除术也是安全可行的.Objective To analyze the characteristics,diagnosis and treatment of cholecystectomy patients in county hospitals,retrospectively.Methods 571 patients with cholecystitis,cholecystolithiasis,gallbladder polyps and other diagnosis surgically treated in Suichang County People's hospital from January 2017 to April 2021 were studied.The etiology,operation and postoperative recovery data were analyzed.Results There were 265 males and 306 females in the 571 patients.480 cases were non-emergent and 91 cases accepted emergency treatment.There were 235 cases with previous symptoms of biliary colic,123 cases with cholecystitis and 213 cases without obvious symptoms.562 cases accomplished operation under laparoscope,9 cases were converted to open surgery,among them,7 cases were in emergency group and 2 cases were in non-emergency group.The operation time,intraoperative bleeding,postoperative complications,postoperative hospital stay and hospitalization cost of emergency operation patients were significantly higher than those of non-emergency patients.Of the 480 non-emergent patients,102 had a history of biliary colic,25 had a history of cholecystitis and 353 had no symptoms within 6 weeks before operation.Compared with asymptomatic patients,the operation time of patients with biliary colic and cholecystitis within 6 weeks was significantly longer,and there was significant difference(P<0.05).Conclusion Among patients accepted cholecystectomy in county hospital,the proportion of patients with acute cholecystitis and recurrent cholecystitis is higher.The patients with recent acute cholecystitis will increase the difficulty of operation,but laparoscopic cholecystectomy is safe and feasible for patients with cholecystitis or cholecystalgia.

关 键 词：胆囊结石 胆囊炎 腹腔镜下胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]