特高海拔地区基层医院援藏手术医师在不同给氧条件下开展小切口胆囊切除术的效果评价

Evaluation of the effectiveness of small-incision cholecystectomy performed by surgeons at extra-high altitude under different conditions of oxygen administration

目的评估内地医疗帮扶手术医师在特高海拔地区基层医院手术过程中不同给氧条件下开展小切口胆囊切除术的完成效果。方法对2022年6-12月那曲市尼玛县人民医院外科收治的39例胆囊结石伴急性或慢性胆囊炎患者的临床资料进行回顾性分析,所有患者均接受小切口胆囊切除术。根据主刀医师在术中是否采用持续低流量吸氧,将对应患者分为2组,对比分析2组患者的手术持续时间及术后恢复情况。结果2组患者的基线指标差异无统计学意义(P>0.05);手术医师在术中使用鼻导管吸氧和非吸氧条件下完成手术时长中位数分别为60、85 min(P=0.006),术中出血量分别为35、80 ml(P=0.005),术后患者肛门恢复通气时间分别为11.50、15.89 h(P<0.001),术后住院天数分别为6和7 d(P=0.006),差异均有统计学意义。结论在特高海拔地区基层医院,手术医师在持续低流量吸氧的条件下开展小切口胆囊切除术,不仅手术过程更为顺利,患者术后恢复也相对更快,对于提高手术效率及患者恢复都有积极作用。

ObjectiveTo evaluate the effectiveness of small-incision cholecystectomy performed by surgeons at extra-high altitude under different conditions of oxygen administration.MethodsThe clinical data of 39 patients who underwent small-incision cholecystectomy after being diagnosed with gallbladder stones accompanied by acute or chronic cholecystitis in Nima County People’s Hospital in Naqu city between June 2022 and December 2022 were retrospectively collected.The patients were divided into two groups according to whether the surgeon received continued low-flow oxygen during the operation.The length of operation and postoperative recovery of the patients in the two groups were compared.ResultsThe baseline characteristics of the two groups of patients were not significantly statistically different(P>0.05),and the median lengths of surgery completed by the surgeon under intraoperative nasal cannula oxygenation and non-oxygenation conditions were 60 minutes and 85 minutes,respectively(P=0.006);the median amounts of intraoperative bleeding were 35 ml and 80 ml,respectively(P=0.005);and the mean time periods for the patients to resume passing gas after surgery were 11.50 hours and 15.89 hours,respectively(P<0.001);the median postoperative hospital stays were 6 and 7 days,respectively(P=0.006).ConclusionSmall-incision cholecystectomy performed by the surgeons under the condition of continuous low-flow oxygen inhalation by nasal cannula can achieve a smoother surgical procedure and a relatively faster postoperative recovery of the patients.