腹腔镜胆道T管探查术后胆道出血原因及治疗

Causes and Treatment of Biliary Hemorrhage After Laparoscopic Biliary T-tube Exploration

目的通过腹腔镜胆道T管探查术进行治疗的患者,对术后患者出现胆道出血的原因进行分析,并针对危险因素提供有效的治疗方法。方法从该院在2014年7月—2019年7月间,收治的需要通过腹腔镜胆道T管探查术后发生胆道出血的患者中随机抽取20例患者,对以上患者的临床资料进行分析研究,分析患者出现胆道出血的主要因素,再根据引发胆道出血的因素,来制定出具有针对效果的治疗方法。其中出血情况较为轻微的,通过非手术方法进行治疗,中度出血的患者通过选择性肝动脉栓塞进行治疗,严重出血的患者则需要通过手术方法进行治疗,治疗后对患者的而生活质量以及并发症的发生情况进行比较。结果患者的并发症发生率5.0%。对于生活质量进行评分,治疗后的生活水平、身体健康、心理、社交评分(51.38±5.16)分、(56.67±5.91)分、(57.46±6.08)分、(56.24±5.69)分均显著高于治疗前的(44.24±4.71)分、(47.98±4.59)分、(45.42±4.78)分、(44.39±4.53)分,差异有统计学意义(t=3.232、3.672、4.923、5.152,P<0.05)。结论通过腹腔镜胆道T管探查术后出现胆道出血的原因多种多样,包括:术中电灼伤引发、术中反复取石引发、放置T型管的管径过粗导致、感染腐蚀胆管壁导致,从而会导致患者出现继发性胆道出血情况,临床中则需要通过预防以及有效的治疗措施进行防治,才能够提高患者的预后效果以及治疗质量。

Objective For patients treated by laparoscopic biliary tract T tube exploration,analyze the causes of postoperative biliary bleeding and provide effective treatments for risk factors.Methods From July 2014 to July 2019 in the hospital,20 patients were randomly selected from patients who required biliary hemorrhage after laparoscopic biliary tract T tube exploration,and the clinical data of the above patients were analyzed and studied,analyze the main factors of patients with biliary bleeding,and then according to the factors that cause biliary bleeding,to develop a treatment method that has an effect.Among them,the bleeding is relatively mild,which is treated by non-surgical methods,patients with moderate bleeding are treated by selective hepatic artery embolization,and patients with severe bleeding need to be treated by surgical methods.After treatment,the patients’quality of life and complications of the disease were compared.Results The incidence of complications was 5.0%.For scoring the quality of life,the quality of life,physi treatment were significantly higher than those before treatment(44.24±4.71)points,(47.98±4.59)points,(45.42±4.78)points,(44.39±4.53)points,the difference was statistically significant(t=3.232,3.672,4.923,5.152,P<0.05).Conclusion There are many reasons for biliary bleeding after laparoscopic biliary tract T-tube exploration,including:intraoperative electrical burns,repeated stone removal during operation,excessive diameter of T-tube placement,and infection of the biliary wall,which will lead to secondary biliary hemorrhage in the patient.In the clinic,prevention and effective treatment measures are required to prevent and cure the patient’s prognostic effect and treatment quality.