关键安全视野理念在南疆地区腹腔镜胆囊切除术的应用研究  

Application of critical view of safety(CVS)concept in laparoscopic cholecystectomy in southern Xinjiang Region

作　　者：章纪豪 萨拉木·米吉提 曹彦龙 汤浩泽 卡哈尔·吐尔逊 廖昊 陈亚进[1] 陈捷[1,2] ZHANG Ji-hao;SALAMU Mi-ji-ti;CAO Yan-long;TANG Hao-ze;KAHAER Tu-er-xun;LIAO Hao;CHEN Ya-jin;CHEN Jie(Department of Hepatobiliary Surgery,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China;Department of Hepatobiliary and Pancreatic Surgery,First People's Hospital of Kashgar,Kashgar,Xinjiang 844000,China;Medical School of Sun Yat-Sen University,Shenzhen,Guangdong 528406,China)

机构地区：[1]中山大学孙逸仙纪念医院肝胆外科,广东广州510120 [2]喀什地区第一人民医院肝胆胰外科,新疆喀什844000 [3]中山大学医学院,广东深圳528406

出　　处：《岭南现代临床外科》2024年第4期215-219,共5页Lingnan Modern Clinics in Surgery

基　　金：广东省农村科技特派员项目(KTPYJ2023025);喀什地区第一人民医院科级项目(KDYY202309);中山大学大学生创新创业训练项目(20242068)。

摘　　要：目的探究关键安全视野(CVS)理念对南疆地区腹腔镜胆囊切除术(LC)安全性及其预后的影响。方法回顾性分析喀什地区第一人民医院2023年5~8月完成的104例LC手术病例的临床资料,将其设置为对照组;同时对2023年9月之后的实施LC的临床医生传输CVS的理念,从同期同中心的病例中纳入符合入组标准的67例LC患者,将其设置为CVS组。收集CVS组患者围手术期各项指标,对比分析对照组和CVS组手术安全性差异及术后恢复情况。结果两组在术前一般情况差异无统计学意义(P>0.05)。CVS组的术中胆道损伤和术后迟发性胆道损伤低于对照组,出血量和术后AST、ALT显著低于对照组,差异有统计学意义(P<0.05)。结论CVS理念能显著提高南疆等基层地区LC的手术安全性,并有效改善预后,预防胆管损伤。Objective To investigate the impact of the critical view of safety(CVS)concept on the safety and prognosis of laparoscopic cholecystectomy(LC)in the southern Xinjiang region.Methods A retrospective analysis was conducted on the clinical data of 104 LC cases performed at the First People's Hospital of Kashgar from May 2023 to August 2023,designated as the control group.Starting in September 2023,the CVS concept was introduced to the clinical doctors performing LC,and 67 LC patients meeting the inclusion criteria from the same period and center were designated as the CVS group.Perioperative indicators of the CVS group were collected,and the safety and postoperative recovery between the control group and the CVS group were compared and analyzed.Results There was no statistically significant difference in the general preoperative conditions between the two groups(P>0.05).The incidence of intraoperative bile duct injury and delayed postoperative bile duct injury was lower in the CVS group compared to the control group.Additionally,blood loss and postoperative AST and ALT levels were significantly lower in the CVS group,with the differences being statistically significant(P<0.05).Conclusion The CVS concept can significantly enhance the safety of LC procedures in primary regions like southern Xinjiang and effectively improve prognosis and prevent bile duct injuries.

关 键 词：南疆地区 CVS 腹腔镜胆囊切除术 胆道损伤 

分 类 号：R657.4[医药卫生—外科学]