| 王荣东,李峰.腹腔镜中转开腹术治疗急性结石性胆囊炎相关因素Logistic回归分析.[J].中南医学科学杂志.,2019,(4):386-388, 399. |
| 腹腔镜中转开腹术治疗急性结石性胆囊炎相关因素Logistic回归分析 |
| Logistic regression analysis of laparoscopic surgery converted to laparotomy in the treatment of complex calculous cholecystitis |
| 投稿时间：2019-01-14 修订日期：2019-06-06 |
| DOI：10.15972/j.cnki.43-1509/r.2019.04.012 |
| 中文关键词: 急性结石性胆囊炎 腹腔镜 中转开腹 胆囊切除术 |
| 英文关键词:cholecystitis laparoscope conversion to laparotomy cholecystectomy |
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| 中文摘要: |
| 腹腔镜胆囊切除术具有一定中转开腹率,分析中转开腹的危险因素对临床术式及治疗时机选择具有重要临床意义。本研究将421例行腹腔镜胆囊切除术的急性结石性胆囊炎患者纳入研究,记录患者中转开腹率、中转开腹原因；收集患者年龄、性别、体温、胆囊肿大情况、右上腹肌紧张、白细胞计数、胆囊壁厚度增加、胆囊颈部结石嵌顿及手术时机等情况。结果发现,中转开腹率为7.60%；体温≥38 ℃、胆囊肿大、上腹肌紧张、白细胞计数≥15×109/L、胆囊颈部结石嵌顿及发病至手术时间间隔与腹腔镜胆囊手术中转开腹相关(P<0.05)；白细胞计数≥15×109/L、胆囊颈结石嵌顿及发病至手术时间间隔>48h为腹腔镜手术中转开腹的独立危险因素(P<0.05)；这些结果提示腹腔镜中转开腹率远期疗效较好,白细胞计数、胆囊颈部结石嵌顿及发病至手术时间间隔为腹腔镜中转开腹术的相关因素。 |
| 英文摘要: |
| Laparoscopic cholecystectomy has a rate of conversion to laparotomy. The analysis of risk factors for conversion to laparotomy has important clinical significance for clinical operation and treatment timing . A total of 421 patients with calculus cholecystitis who underwent laparoscopic cholecystectomy were enrolled in the study. The rate and causes of conversion to laparotomy were recorded. The conditions such as age, gender, body temperature, gallbladder enlargement, right upper abdominal muscle tension, white blood cell count, gallbladder wall thickening, gallbladder neck stone incarceration and timing of surgery were collected. The results shows that the conversion rate was 7.60%. Body temperature ≥38 ℃, gallbladder enlargement, upper abdominal muscle tension, white blood cell count≥15×109/L, gallbladder neck stone incarceration and time interval from onset to surgery >48h were related to laparoscopic cholecystectomy converted to laparotomy (P<0.05). Logistic regression analysis showed that white blood cell count ≥15×109/L, gallbladder neck stone incarceration and time interval from onset to surgery >48h were independent risk factors for conversion to laparotomy during laparoscopic surgery (P<0.05). The results suggested that the long-term curative effect of laparoscopic surgery converted to laparotomy is good. White blood cell count, gallbladder neck stone incarceration and time interval from onset to surgery are related factors of conversion to laparotomy. |
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