腹腔镜胆囊切除术并发症发生率及其影响因素

Incidence of complications and affecting factors in laparoscopic cholecystectomy

目的:探讨腹腔镜胆囊切除术(LC)患者手术并发症的发生率和影响因素。方法:采用自编调查表,回顾性分析近两年间收治的500例LC患者临床资料,分析手术并发症的发生率和影响因素。结果:LC并发症发生率为2.60%,单因素Logistic回归分析显示,LC并发症与高龄、手术性质、手术时间、切口类型、胆囊与周围脏器粘连,胆囊颈结石、Calot三角粘连、胆囊壁厚、合并糖尿病、手术室各区域布局、放置引流有关(均P<0.05);多因素Logistic回归分析表明,高龄、急诊手术、胆囊与周围脏器粘连、Calot三角粘连和合并糖尿病是LC并发症的危险因素,而手术室各区域合理布局和放置引流是防止LC并发症的重要因素(均P<0.05)。结论:LC患者手术并发症的发生较常见,且受多种因素的影响。

Objective：To investigate the incidence of complications in laparoscopic cholecystectomy and the affecting factors.Methods：The clinical data of 500 patients undergoing laparoscopic cholecystectomy over the recent two years were analyzed by using self-designed investigation scale to determine the incidence of complications in laparoscopic cholecystectomy and the affecting factors.Results：The overall incidence of complications of laparoscopic cholecystectomy was 2.60%.Univariate Logistic regression analysis showed that the incidence of complications following laparoscopic cholecystectomy was associated with old age,type of surgery,type of incision,adhesions of agllbladder to adjacent viscera,adhesions in Calot’s triangle,gallbladder wall thickening,concomitant diabetes,regional distribution of the operation room and drainage tube placement（all P＆lt;0.05）.Mutivariate Logistic regression analysis revealed that old age,emergency operation,adhesions of gallbladder to adjacent viscera,adhesions in Calot’s triangle and concomitant diabetes were risk factors for occurrence of complications following laparoscopic cholecystectomy,while rational arrangement of the operation room and drainage tube placement were important factors for prevention of the occurrence of complications（all P＆lt;0.05）.Conclusion：The incidence of complications in laparoscopic cholecystectomy is relatively high,and is affected by various factors.