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  

Clinical Outcomes of Emergency Primary Surgery and Controlled Surgery in the Treatment of Hepatobiliary Trauma

作　　者：唐成 TANG Cheng(Department of General Surgery,The First People's Hospital of Xiaogan City,Xiaogan 432000,China)

机构地区：[1]孝感市第一人民医院普外科,湖北孝感432000

出　　处：《中华灾害救援医学》2024年第6期703-706,共4页Chinese Journal of Disaster Medicine

摘　　要：目的比较肝胆外科损伤患者分别采取急诊Ⅰ期手术和控制性手术的临床疗效。方法回顾性分析2021年6月至2023年6月孝感市第一人民医院救治的94例肝胆外科损伤患者的资料,根据手术方案的不同,分为观察组与对照组,每组47例。观察组患者采用控制性手术方案,对照组患者采用急诊Ⅰ期手术方案。比较两组患者住院相关指标、炎症指标、凝血指标、术后并发症和死亡率。结果观察组患者手术时间、体温恢复时间及住院时间均显著短于对照组(P<0.001)。手术前,两组患者炎症指标白细胞(WBC)、C-反应蛋白(CRP)及凝血指标活化部分促凝血酶原激酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)均无显著差异(P>0.05);手术后,观察组患者WBC、CRP、APTT、PT、TT水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为8.51%,显著低于对照组的38.30%,差异有统计学意义(P<0.05);观察组死亡率为6.38%,与对照组的17.02%相比,差异无统计学意义(P>0.05)。结论对肝胆外科损伤患者采取控制性手术方案,可缩短患者手术时间、体温恢复时间及住院时间,降低炎症因子水平,有利于维持凝血功能的稳定性,降低术后并发症的发生率。Objective To compare the clinical efficacy of emergency primary surgery and controlled surgery in patients with hepatobiliary surgical injury.Methods A retrospective analysis was conducted on the data of 94 patients with hepatobiliary surgical injurytreated at the Xiaogan First People's Hospital from June 2021 to June 2023.Based on the surgical approach,the patients were divided into the observation group and the control group,with 47 cases in each group.The control group underwent emergency primary surgery,while the observation group received controlled surgery.The hospitalization-related indicators,inflammatory markers,coagulation parameters,postoperative complications,and mortality rates were compared between the two groups.Results The observation group had significantly shorter surgery duration,time to temperature recovery,and hospital stay compared to those of the control group(P<0.001).Before surgery,there were no significant differences in inflammatory markers(WBC,CRP)and coagulation parameters(APTT,PT,TT)between the two groups(P>0.05).After surgery,the levels of WBC,CRP,APTT,PT,and TT in the observation group were significantly lower than those in the control group(P<0.05).The incidence of complications in the observation group was 8.51%,which was significantly lower than the 38.30%in the control group,with statistical significance(P<0.05).The mortality rate in the observation group was 6.38%,while it was 17.02%in the control group,and there was no statistically significant difference between the two groups(P>0.05).Conclusion For patients with hepatobiliary surgical injury,the adoption of controlled surgery approach can shorten surgery duration,time to temperature recovery,and hospital stay,reduce inflammatory marker levels,help maintain coagulation function stability,and reducethe incidence of postoperative complications.

关 键 词：急诊处理 胆道外科手术 出血 炎症趋化因子类 凝血酶原 

分 类 号：R605[医药卫生—外科学]