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find Keyword "急性结石性胆囊炎" 4 results
  • 超声诊断在胆囊三角中的应用

    目的探讨B型超声测定术前急性结石性胆囊炎胆囊壁厚度与术中胆囊三角显示之间的关系。 方法将2011年7月-2012年12月42例急性结石性胆囊炎患者,按术前B型超声提示的胆囊壁厚情况分为壁厚≥4 mm组(n=17)和<4 mm组(n=25),分析胆囊三角与胆囊壁厚之间的关系。 结果42例患者术中胆囊三角可显示率为52.4%,其中胆囊壁厚≥4 mm组显示率仅为17.6%,<4 mm组显示率为76.0%,两组在术中胆囊三角分离显示率比较,差异有统计学意义(P<0.05)。随着胆囊壁厚度的增加,胆囊三角显示清晰度减低。 结论术前B型超声测定急性结石性胆囊炎胆囊壁厚,可间接提示胆囊三角显露难易程度,指导急性结石性胆囊炎患者手术时机与方法的选择,避免因胆囊三角显示不清而造成胆道损伤。

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  • 腹腔镜与开腹胆囊切除术治疗急性结石性胆囊炎的疗效分析

    目的比较腹腔镜胆囊切除术(LC)与开腹胆囊切除术(OC)治疗急性结石性胆囊炎的术后恢复及并发症。 方法将2009年1月-2014年1月收治的230例急性结石性胆囊炎患者按其手术方式分为OC组93例和LC组137例。比较两组患者术后的疼痛、发热、进食时间、住院时间和并发症发生率。 结果LC组与OC组术后3 d内疼痛发生率分别为68.8%、37.9%,发热发生率分别为8.8%、40.9%;LC组进食时间更早,术后第1天两组进食患者分别占77.3%、7.5%;LC组住院时间更短,两组分别为(5.0±1.8)、(8.2±2.4)d;以上差异均具有统计学意义(P<0.001)。两组均无胆管损伤患者;LC组术后胆漏2例,术后出血1例;OC组术后胆漏1例,术后出血1例,切口感染3例;并发症均在保守治疗后治愈。 结论与OC相比,LC治疗急性结石性胆囊炎同样具有安全性,未增加术后并发症发生率,并且具有创伤小、痛苦少、恢复快、住院时间短等优点,是治疗急性结石性胆囊炎的理想术式。

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  • Effect of Sequentially Mini-Invasive Method for Elderly Acute Calculous Cholecystitis Patients Combined with Organ Dysfunction Syndrome

    ObjectiveTo explore the curative effect and the appropriate time of sequentially with minimal invasive methods in treatment of elderly acute calculous cholecystitis patients combined with organ dysfunction syndrome (ODS). MethodsClinical data of 67 elderly acute calculous cholecystitis patients combined with ODS who received treatment in our hospital from December 2010 to December 2013 were collected retrospectively. All of the 67 patients were treated with percutaneous transhepatic gallbladder drainage (PTGBD) under the guidance of B ultrasound or CT at first, as well as systemic anti infective therapy, and then underwent laparoscopic cholecystectomy (LC) sequentially when situation of body got well. ResultsAll of the 67 patients (100%) were treated with PTGBD successfully, but only 65 patients finished the latter related test. For the 65 patients, compared with before PTGBD, the patient's pain, abdominal distention, vomiting, leukocyte count, neutrophil ratio, glutamic-pyruvic transaminase, total bilirubin, C-reactive protein, and temperature had gotten obviously better on 1 and 4 d after PTGBD (P<0.05). There were 3 patients dropped LC, 2 patients transferred to mini-incision cholecystectomy, and the rest of 60 patients underwent LC successfully. All of the patients recovery and discharged from hospital in 2-7 days after operation. ConclusionSequentially mini-invasive method is a simple, easy, safe, effective, mini trauma, and quick recovery method for the elderly acute cholecystitis patients combined with the ODS.

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  • 急性结石性胆囊炎腹腔镜手术时机的选择及其对生活质量的影响

    目的总结急性结石性胆囊炎腹腔镜手术时机的选择及其对生活质量的影响。 方法回顾性收集笔者所在医院于2013年5月至2015年5月期间收治的200例行腹腔镜手术的急性结石性胆囊炎患者,按手术距症状出现时间分为4组:<24 h组62例、24~48 h(含48 h)组58例、48~72 h(含72 h)组47例及>72 h组33例,比较4组患者的术中出血量、手术时间、术后住院时间、住院费用、中转开腹率及术后短期并发症发生率,并比较4组患者术前、出院时及术后6个月时的消化病生存质量指数(GLQI)评分。 结果<24 h组患者的术中出血量和手术时间均少于或短于24~48 h组、48~72 h组及>72 h组(P<0.05),且>72 h组的上述2个指标均多于或长于24~48 h组和48~72 h组(P<0.05);>72 h组的住院时间和中转开腹率均长于或高于<24 h组、24~48 h组及48~72 h组(P<0.05)。术前4组患者的GLQI评分比较差异无统计学意义(P>0.05);出院时<24 h组患者的GLQI评分高于24~48 h组、48~72 h组和>72 h组(P<0.05);术后6个月时4组患者的GLQI评分比较差异无统计学意义(P>0.05)。 结论急性结石性胆囊炎患者发病72 h内为腹腔镜下胆囊切除的手术时机,尤其在24 h内行腹腔镜胆囊切除术不仅安全可行,而且有利于提高患者出院时的生活质量。

    Release date:2016-12-21 03:35 Export PDF Favorites Scan
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