肝门阻断在中度急性胆囊炎手术中的效果评价  

Effect evaluation of pringle maneuver in moderate acute cholecystitis surgery

作　　者：赵海远 马俊永 刘刚 李阳[1] 杨万超 赵军[1] Zhao Haiyuan;Ma Junyong;Liu Gang;Li Yang;Yang Wanchao;Zhao Jun(Yijishan Hospital of Wannan Medical College(The First Affiliated Hospital of Wannan Medical College),Wuhu,Anhui 241000,China;The Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China)

机构地区：[1]皖南医学院弋矶山医院(皖南医学院第一附属医院),安徽芜湖241000 [2]海军军医大学第三附属医院,上海200438

出　　处：《齐齐哈尔医学院学报》2024年第5期425-429,共5页Journal of Qiqihar Medical University

基　　金：安徽省自然基金项目(1808085MH271);2021年皖南医学院校中青年科研基金(WK2021F17、WK2021F07)。

摘　　要：目的评价肝门阻断在中度急性胆囊炎手术中预防出血和胆瘘的效果。方法回顾性分析2021年5月—2023年5月本院收治的内中度急性胆囊炎接受胆囊切除手术的患者资料。共计纳入160例患者,其中60例接受了肝门阻断(阻断组),另外100例没有接受肝门阻断(传统组)。对两组患者的基本信息、临床资料和术后并发症等指标进行统计分析。结果与传统组相比,阻断组手术时间明显缩短、术中出血量明显减少、住院时间短、术中胆道损伤和胆囊床残余胆囊均较少(P<0.05)。两组的术后并发症中阻断组术后胆瘘的发生率为1.7%,明显减少(P<0.05);术后出血、切口感染和再次入住ICU均未见明显差异(P>0.05)。结论在中度急性胆囊炎手术中,肝门阻断是一种有效的手术技术可以改善围手术期结果和减少术后胆瘘的发生。Objective To assess the effectiveness of pringle maneuver in preventing bleeding and bile leakage during surgery for moderate acute cholecystitis.Methods We retrospectively analyzed the data of patients who underwent cholecystectomy due to moderate acute cholecystitis in the first affiliated hospital of Wannan Medical College from May 2021 to May 2023.A total of 160 patients were included in the study,of which 60 underwent hepatic pedicle clamping(clamping group)and 100 did not receive hepatic pedicle clamping(conventional group).The baseline characteristics,clinical data,and postoperative complications were statistically analyzed.Results Compared to the conventional group,operation time was significantly shortened,intraoperative blood loss reduced,length of hospital stay shortened,intraoperative bile duct injuries and residual gallbladders on the gallbladder bed were fewer in the clamping group(P<0.05).The incidence of postoperative bile leakage in the clamping group was 1.7%,which was significantly reduced(P<0.05).There were no significant differences in postoperative bleeding,incision infection,and ICU readmission between the two groups(P>0.05).Conclusions In surgery for moderate acute cholecystitis,hepatic pedicle clamping is an effective surgical technique that can improve perioperative outcomes and reduce the occurrence of postoperative bile leakage.

关 键 词：中度急性胆囊炎 肝门阻断 胆囊切除术 围手术期 并发症 

分 类 号：R657.8[医药卫生—外科学]