肝胆外科损伤控制性手术临床应用疗效分析

Analysis of clinical application of control surgery in Hepatobiliary Surgery

目的分析总结肝胆外科损伤控制性手术的临床疗效,为肝胆外科治疗提供参考。方法对2013年1月-2014年1月在黑龙江省鹤岗矿业集团公司总医院普外科进行手术治疗的38例肝胆损伤患者的临床资料进行回顾性分析,根据手术方法将38例患者分成常规手术组与控制性手术组,每组19例。常规手术组采取常规的Ⅰ期手术,控制性手术组采取控制性外科手术,比较两组患者的手术基本资料(手术时间,术中出血量,住院时间),术后并发症发生率及病死率。结果控制性手术患者的手术时间,术中出血量及术后的住院时间都明显的较常规手术组短,差异有统计学意义(P<0.01)。常规手术组术后并发症发生率为68.42%(13/19),控制性手术组术后并发症发生率为26.32%(5/19),常规手术治疗组与控制性手术组相比,并发症发生率较高,差异有统计学意义(P<0.01)。两组患者的随访都顺利完成。常规手术组的病死率为36.84%(7/19),控制性手术组的病死率为10.53%(2/19),常规手术组的病死率明显高于控制性手术组差异有统计学意义(P<0.01)。结论控制性手术可减少肝胆外科损伤患者的并发症发生率及病死率,改善患者的预后,有临床应用的意义。

Objective To analyze clinical curative effect of damage control surgery, and provide reference for treatment. Methods January 2013- January 2014 in the department of general surgery in our hospital,the clinical data of 38 patients with liver injury were retrospectively analyzed. According to the operation method they were divided into two groups, conventional surgery group and the control treatment group, 19 cases in each group. Conventional surgery group adopted conventional Ⅰ operation, the control treatment group took control surgery, compared two surgery for patients with basic information（operation time,intraoperative blood loss, hospital stay）, the incidence of postoperative complications and mortality.Results Control surgery treatment group with operation time, intraoperative blood loss and postoperative hospital stay were obviously better than those in the conventional surgery group, with statistical significance（P 0.01）. Routine surgical complication rate was 68.42%（13/19）, control treatment group postoperative complication rate was 26.32%（5/19）, complications of conventional surgical treatment was obviously higher than that of control treatment group, with statistical significance（P〈0.01）. Two groups of patients with complete follow-up, the mortality of conventional surgery group was 36.84%（7/19）, control treatment group mortality was 10.53%（2/19）, the case fatality rate of conventional surgery group was obviously higher than that of control treatment,with statistical significance（P〈0.01）. Conclusion Control operation can reduce the incidence of complications and mortality of patients with injury of liver and gallbladder surgery, improve the prognosis of patients, there is significance in clinical application.