腹腔镜胆囊切除术围手术期并存病的处理体会

The experience of the treatment for comorbidities in perioperative period of laparoscopic cholecystectomy

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)围手术期并存病的处理。方法:回顾分析LC1 670例中296例并存病的临床资料,其中高血压136例,冠心病74例,糖尿病86例。经围手术期正确处理后行LC术。结果:术中1例死于严重心率失常,1例术后9d死于恶性高血压,酸碱平衡紊乱,其余手术均获成功。结论:在重视避免手术严重并发症的同时,术前需对患者并存病作出合理评估和治疗,以减少术中并存病引发的不良后果。加强围手术期并存病的处理,对降低LC围手术期病死率有重要意义。

Objective： To explore the treatment for comorhidities in perioperative period of laparoseopie cholecystectomy. Methods： The data of 1 670 patients who underwent laparoseopie cholecystectomy were retrospectively analyzed. There were 296 patients with comorbidities including 136 patients with high blood pressure ,74 patients with coronary artery disease and 86 patients with diabetes who had been correctly treated before laparoseopie cholecystectomy. Results： One patient died of serious cardiac arrhythmias intraoperatively and one ease died of malignant hypertension and disturbance of acid-base balance on ninth day after operation, The remaining patients successfully underwent operation. Conelnsions：It is essential to evaluate and improve the patients with comorhidities before operation, in order to reduce harmful consequence incurred by eomorbidities. Strengthening the treatment for comorhidities plays an important role in reducing the mortality in periopetative period.