结石嵌顿坏疽性胆囊炎手术治疗及并发症预防

Surgical treatment of calculous incarcerated gangrenous cholecystitis and prevention of complications

目的探究结石嵌顿坏疽性胆囊炎手术的治疗效果及并发症预防措施。方法选取2016年1月至2017年1月我院收治的结石嵌顿坏疽性胆囊炎患者53例,均采用手术切除治疗,术前采用B超、CT或磁共振胰胆管造影(MRCP)确定结石部位、类型等,治疗期间实施针对性护理措施预防并发症,观察治疗效果。结果所有研究对象均手术切除成功,切除率为100%;手术平均时间为(80.56±7.35)min,术中出血量为(120.34±5.51)m L,住院时间为(9.73±2.21)d。53例患者中胆漏2例,腹腔内出血1例,术后感染1例,肺部感染2例,并发症总发生率为11.32%。结论结石嵌顿坏疽性胆囊炎手术治疗前行影像学检查,可优化术中操作,注重围手术期护理,可有效提高手术治疗效果,减少术后并发症。

Objective To investigate the effect of surgical treatment of gangrenous cholecystitis and the prevention of complications. Methods Fifty-three patients with specific gangrenous cholecystitis in our hospital from January 2016 to January 2017 were selected as the study subjects. All patients underwent surgical resection and B-ultrasound, CT or MRCP to determine the location of stones, type. During the operation, targeted care measures were conducted to prevent complications. The effect of treatment was observed. Results All the patients were successful in surgical resection, and the resection rate was 100%. The average time of operation was（80.56±7.35） min, the intraoperative blood loss was（120.34±5.51） m L, and the hospitalization time was（9.73 ±2.21） d. Of 53 patients, there were 2 cases of bile leakage, 1 case of intra-abdominal hemorrhage, 1 case of postoperative infection, 2 cases of pulmonary infection, the total incidence rate of complications was 11.32%. Conclusion It can optimize intraoperative operation to perform imaging detection before calculous incarcerated gangrenous cholecystitis surgery, and combined with perioperative nursing can effectively improve the effect of surgical treatment and reduce the postoperative complications.