胆囊良性病变患者经脐单孔腹腔镜手术时间延长的影响因素分析  

Analysis of related factors affecting the prolongation of time for transumbilical single-port laparoscopic surgery in patients with benign gallbladder lesions

作　　者：张鹏 张李 仁青才让 张彬 丁智才让 吴文辉 鲁明辉 侯宝英 ZHANG Peng;ZHANG Li;RENQING Cairang;ZHANG Bin;DINGZHI Cairang;WU Wenhui;LU Minghui;HOU Baoying(Second Department of General Surgery,Gannan Prefecture People's Hospital,Gansu Province,Gannan 747000,China;Department of Gastric Oncology,Tianjin Medical University Cancer Institute&Hospital,Tianjin 300060,China)

机构地区：[1]甘肃省甘南州人民医院普外二科,甘肃甘南747000 [2]天津医科大学肿瘤医院胃部肿瘤科,天津300060

出　　处：《中国当代医药》2023年第17期73-76,共4页China Modern Medicine

摘　　要：目的分析影响胆囊良性病变患者经脐单孔腹腔镜手术时间延长的相关因素。方法回顾性分析2020年6月至2022年6月于甘肃省甘南州人民医院进行经脐单孔腹腔镜手术的100例胆囊良性病变患者病历资料,纳入患者的手术中位时间为80 min,将手术时间≥80 min的患者作为延长组,共45例;手术时间<80 min的患者作为对照组,共55例。收集两组患者的病历资料并进行比较,分析影响胆囊良性病变患者经脐单孔腹腔镜手术时间延长的相关因素。结果延长组患者的体重指数(BMI)≥24 kg/m^(2)、上腹部手术史比例、合并肝硬化比例、胆囊壁厚度<3 mm比例、胆囊萎缩比例、术前白细胞计数>10×10^(9)/L和中转开腹比例高于对照组,差异均有统计学意义(P<0.05);多因素logistic回归模型进行分析显示,BMI≥24 kg/m^(2)(β=0.581,OR=1.788,95%CI=1.299~2.461)、上腹部手术史(β=1.568,OR=4.797,95%CI=2.582~8.912)、胆囊壁厚度>3 mm(β=1.489,OR=4.433,95%CI=2.335~8.414)、术前白细胞>10×10^(9)/L(β=1.626,OR=5.083,95%CI=2.452~10.539)、胆囊萎缩(β=0.185,OR=1.203,95%CI=1.043~1.388)、合并肝硬化(β=0.233,OR=1.262,95%CI=1.020~1.563)和中转开腹(β=1.735,OR=5.669,95%CI=2.886~11.213)是胆囊良性病变患者经脐单孔腹腔镜手术时间延长的独立危险因素(P<0.05)。结论胆囊良性病变患者在进行经脐单孔腹腔镜手术前应充分考虑患者的BMI、上腹部手术史、胆囊壁厚度、白细胞计数、胆囊萎缩以及其他合并症等可能存在的危险情况,从而帮助提高手术安全性。Objective To analysis the relevant factors affecting the prolongation of time for transumbilical single-port laparoscopic surgery in patients with benign gallbladder lesions.Methods A total of 100 patients with benign gallbladder lesions who underwent transumbilical single-port laparoscopy in the Gansu Gannan People's Hospital from June 2020 to June 2022 were retrospectively analysed.The median surgical time for patients included was 80 minutes,patients with a surgical time of≥80 minutes were included in the extended group,with a total of 45 patients.Patients with surgery time<80 minutes served as the control group,with a total of 55 cases.The medical records of two groups of patients were collected and compared,and the relevant factors affecting the prolongation of time for transumbilical single-port laparoscopic surgery in patients with benign gallbladder lesions were analyzed.Results Body mass index(BMI)≥24 kg/m^(2),proportion of epigastrium surgery history,proportion of patients with cirrhosis,proportion of patients with gallbladder wall thickness<3 mm,proportion of patients with gallbladder atrophy,and preoperative white blood cell count>10×10^(9)/L and conversion to open surgery were higher than those of the control group,and the differences were statistically significant(P<0.05).The logistic regression model was used for multiple factor analysis to show that,BMI≥24 kg/m^(2)(β=0.581,OR=1.788,95%CI=1.299-2.461),history of epigastrium surgery(β=1.568,OR=4.797,95%CI=2.582-8.912),gallbladder wall thickness>3 mm(β=1.489,OR=4.433,95%CI=2.335-8.414),preoperative white blood cells>10×10^(9)/L(β=1.626,OR=5.083,95%CI=2.452-10.539),gallbladder atrophy(β=0.185,OR=1.203,95%CI=1.043-1.388),concomitant liver cirrhosis(β=0.233,OR=1.262,95%CI=1.020-1.563)and conversion to open laparotomy(β=1.735,OR=5.669,95%CI=2.886-11.213)were independent risk factors for prolonged time of transumbilical single-port laparoscopic surgery in patients with benign gallbladder lesions(P<0.05).Conclusion Before performing transumb

关 键 词：胆囊良性病变 经脐单孔腹腔镜手术 手术时间 相关因素 

分 类 号：R441.5[医药卫生—诊断学]