| 吴媛,操云芳,赵解.腹腔引流管对腹腔镜胆囊切除患者术后康复的影响[J].安徽医药,2018,22(1):111-114. |
| 腹腔引流管对腹腔镜胆囊切除患者术后康复的影响 |
| Effect of abdominal cavity drainage tube on the rehabilitation of patients after laparoscopic cholecystectomy |
| 投稿时间：2017-04-05 |
| DOI： |
| 中文关键词: 腹腔镜胆囊切除术 引流管 早期康复 加速康复外科 |
| 英文关键词: laparoscopic cholecystectomy drainage tube early rehabilitation enhanced recovery after surgery |
| 基金项目: |
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| 摘要点击次数: 2001 |
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| 中文摘要: |
| 目的 探讨腹腔镜胆囊切除术(LC)术后放置引流管对患者早期康复的影响。方法 回顾性搜集行LC的90例患者的临床资料,按照术后是否放置引流管分为观察组48例,术后均未放置腹腔引流管；对照组42例,术后常规预防性放置腹腔引流管。比较两组患者性别、年龄、术前住院时间、术前诊断、合并症、手术时间、术中出血量、术后疼痛评分、术后进食时间、肛门排气时间、排便时间、下床活动时间、总住院时间、并发症等情况。结果(1)两组患者的性别、年龄、术前住院时间、术前诊断、合并症数据差异无统计学意义(P>0.05)；手术时间、术中出血量数据差异有统计学意义(P＜0.05)。(2)观察组患者术后1、4、8、12、24、48及72 h的疼痛评分均明显低于对照组,数据差异有统计学意义(P＜0.01)。(3)两组患者术后进食时间比较差异无统计学意义(P>0.05)；观察组术后肛门排气、排便时间及下床活动时间均明显短于对照组,数据差异有统计学意义(P<0.01),观察组总住院时间明显短于对照组,数据差异有统计学意义(P<0.05)。(4)观察组恶心呕吐的发生率明显低于对照组,数据差异有统计学意义(P<0.05),其他并发症如尿潴留、腹胀、胆瘘等在两组间比较差异无统计学意义(P>0.05)。结论 LC手术放置腹腔引流管应根据术中情况严格掌握指征,不放置引流管具有疼痛轻、胃肠功能恢复快、住院时间短、并发症少的优点,更有利于患者的早期康复。 |
| 英文摘要: |
| Objective To investigate the effect of abdominal cavity drainage tube on the early recovery of the patients after laparoscopic cholecystectomy (LC). Methods We collected and studied the clinical data of 90 cases that had underwent LC in the department of general surgery of Tongling Fourth People′s Hospital from March 2015 to November 2016.They were assigned into observation group(without postoperative drainage tube,n=48) and control group (with preventive postoperative drainage tube,n=42).The two groups were compared in gender,age,preoperative length of stay,preoperative diagnosis,comorbidities,operative duration,transoperative bleeding volume,postoperative pain scores,first eating time,anal exhaust time,first defecation time,out-of-bed time,total length of stay,postoperative complications and so on. Results ① There were no statistically significant differences between the two groups in gender,age,preoperative length of stay,preoperative diagnosis and comorbidities (P>0.05),and there were statistically significant differences in operative duration and transoperative bleeding volume (P<0.05).② Compared with the control group,the patients in the observation group had lower postoperative pain scores at 1,4,8,12,24,48 and 72 hours after operations (P<0.01).③ The two groups had similar time of postoperative first eating (P>0.05).The time of first anal exhaust,first defecation and getting out of bed postoperatively were remarkably shorter in the observation group than in the control group (P<0.01) and so was the total length of stay (P<0.05).④ The incidence of nausea and vomiting in the observation group was significantly lower than that in the control group (P<0.05),while no statistically significant differences were found in other complications like urinary retention,abdominal distension,biliary fistula between the two groups (P>0.05). Conclusions Surgeons should be very cautious in placing abdominal cavity drainage tube following LC based on the premise that the indications are present.It is more beneficial to the patients′ rehabilitation without the placement of abdominal cavity drainage tube,which has advantages of less pain and postoperative complications,faster intestinal function recovery,and shorter length of stay. |
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