7572例单纯胆囊切除术中并发症发生因素的分析

An analysis of the causes of complication in 7572 cases of simply cholecystectomy operation

目的 探讨单纯胆囊切除术中并发症的发生因素。方法 采用自制单病种麻醉质控调查表 ,回顾性调查 4年内全市县级 (Ⅱ级 )以上医院行单纯胆囊切除手术患者 75 72例 ,观察不同麻醉方法和不同级别医院中并发症的发生率。结果 硬膜外阻滞组患者神经反射、心血管抑制、呼吸抑制及肺部感染的发生率与全麻组间差别有显著性意义 (P <0 0 1)。而全麻患者术毕时麻醉苏醒期血压、心率明显升高 (P <0 0 1)。在不同级别医院手术的患者术中并发症的发生率间差别有显著性意义 (P <0 0 1)。结论 单纯胆囊切除术选择全麻比硬膜外阻滞麻醉并发症要少 ,但苏醒期存在着隐患。因此 ,必须重视术前准备 ,加强围术期麻醉管理与监测 ,采取综合的预防和治疗措施 ,可提高患者的安全性。

Objective To study the cause of complication during simply cholecystectomy operation.Methods By using the investigative lists about the quantity of anesthesia designed by ourselves, we retrospect ed and analyzed 7572 cases of simply cholecystectomy operation accomplished in our city during 4 years in the hospitals, whose grade are above 2, to observe the relationship of complications with different anesthesia methods and in different hospitals.Results The complication increased apparently in epidural anesthesia team, especially in side of reflex of nerve, inhibition of circulation and respiration, it is different from that in general anesthesia team obviously(P<0.01). However, in resuscitation period the blood pressure and heart rate of the patients with general anesthesia would increase apparently(P<0.01).Conclusion Compared with epidural anesthesia, in simply cholecystectomy operation, choosing general anesthesia can decrease the complication, but there is still hidden trouble in resuscitation period. Therefore, to increase the patient's safety, we must take the preparation before operation seriously, strengthen the per operative management and monitor, then adopt integration of prevention and therapy measure.