比较急诊Ⅰ期手术和控制性手术治疗肝胆外科损伤的临床效果  

Comparing Clinical Outcomes of Emergency PhaseⅠSurgery and Con⁃trolled Surgery for Hepatobiliary Surgical Injuries

作　　者：郑福榕 魏振铨[1] 胡安然[1] 郑志铭 ZHENG Furong;WEI Zhenquan;HU Anran;ZHENG Zhiming(Department of General SurgeryⅡ,Sanming Second Hospital,Sanming,Fujian Province,366100 China)

机构地区：[1]三明市第二医院普外二科,福建三明366100

出　　处：《中外医疗》2022年第32期67-70,75,共5页China & Foreign Medical Treatment

摘　　要：目的 分析急诊Ⅰ期手术、控制性手术治疗肝胆外科损伤临床效果。方法 回顾性分析三明市第二医院2016年1月—2020年12月54例肝胆外科损伤患者临床资料,依据不同治疗方案分为对照组(n=17)、观察组(n=37),对照组实施急诊Ⅰ期手术治疗,观察组实施控制性手术治疗,比较两组患者康复用时,术前及术后1周凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)],炎症反应指标[白细胞计数(WBC)、C反应蛋白(CRP)],肝功能指标[总胆红素(TBiL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)],并发症发生率、病死率。结果 观察组体温恢复时间、pH恢复时间、住院时间均较对照组短,差异有统计学意义(P<0.05);术后1周,观察组APTT、PT、TT、WBC、CRP、TBil、ALT、AST水平均较对照组低,差异有统计学意义(P<0.05);观察组并发症发生率为2.70%,较对照组29.41%低,差异有统计学意义(χ^(2)=5.926,P<0.05);观察组病死率为5.41%,与对照组5.88%差异无统计学意义(P>0.05)。结论 对肝胆外科损伤患者实施控制性手术治疗可缩短患者康复用时,改善患者肝功能、凝血功能,降低炎症因子水平及并发症发生率。Objective To analyze the clinical effects of emergency stage I surgery and controlled surgery for hepatobili⁃ary surgical injuries.Methods The clinical data of 54 patients with hepatobiliary surgery injuries in Sanming Second Hospital from January 2016 to December 2020 were retrospectively analyzed.According to different treatment plans,the patients were divided into control group(n=17)and observation group(n=37).The control group was treated with emergency stageⅠsurgery,while the observation group was treated with controlled surgery.The recovery time,coagu⁃lation function[prothrombin time(PT),activated partial thrombin time(APTT),thrombin time(TT)],inflammatory re⁃sponse indexes[white blood cell count(WBC),C-reactive protein(CRP)],liver function indexes[total bilirubin(TBiL),transaminase(ALT),aspartate aminotransferase(AST)],incidence of complication and case fatality were com⁃pared between the two groups.Results The temperature recovery time,pH recovery time and hospital stay in the obser⁃vation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The levels of APTT,PT,TT,WBC,CRP TBil,ALT and AST and in the observation group were lower than those in the control group one week after surgery,the difference was statistically significant(P<0.05).The incidence of complica⁃tions in the observation group was 2.70%,lower than 29.41%in the control group,and the difference was statistically significant(χ^(2)=5.926,P<0.05).The case fatality rate of the observation group was 5.41%that of the control group(5.88%),the difference was not statistically significant(P>0.05).Conclusion The implementation of controlled surgi⁃cal treatment for patients with hepatobiliary surgical injuries can shorten the time spent on recovery,improve patients'liver function and coagulation function,and reduce the level of inflammatory factors and the incidence of complica⁃tions.

关 键 词：肝胆外科 控制性手术治疗 急诊Ⅰ期手术 

分 类 号：R657[医药卫生—外科学]