本文關鍵詞： 腹腔鏡 一期縫合 膽道壓力 膽道測壓　出處：《中國微創(chuàng)外科雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的通過經(jīng)膽囊管細管引流測量術后不同時間患者的膽道壓力,觀察是否存在術后壓力持續(xù)增高。方法 2013年1月~2014年6月對52例行腹腔鏡膽囊切除,膽總管切開取石一期縫合術行膽道壓力測定。采用經(jīng)膽囊管留置細管進入膽道進行測壓,通過中心靜脈壓的裝置測量,分別測定術后第3、7、11天膽道壓力。結果 3例術后第3天出現(xiàn)膽漏,第6天消失。所有患者順利出院,無并發(fā)癥。術后第3、7、11天膽道壓力分別為(20.49±1.44)、(16.09±1.48)、(11.29±1.74)cm H2O,兩兩比較均有統(tǒng)計學差異(P均=0.000)。結論腹腔鏡下膽囊切除,膽總管切開取石一期縫合術后膽道壓力逐漸降低,膽漏最可能在術后3 d左右發(fā)生,術后第7、11天后膽漏的機會明顯減少。一期縫合的病人出院時并不增加膽道壓力,不增加出院后膽漏風險。
[Abstract]:Objective to measure the biliary tract pressure of patients with cholecystic duct drainage at different time after operation and to observe whether there is a continuous increase in postoperative pressure. Methods 52 patients underwent laparoscopic cholecystectomy from January 2013 to June 2014. Choledocholithotomy and primary suture were performed to measure the pressure of bile duct. Bile duct pressure was measured on the 3rd day, 7th day and 11th day after operation. Results the bile leakage occurred on the 3rd day after operation and disappeared on the sixth day. All the patients were discharged smoothly. There was no complication. The pressure of bile duct was 20.49 鹵1.44 and 11.29 鹵1.74 cm H _ 2O on the 3rd and 7th day after operation, respectively. Conclusion the pressure of bile duct gradually decreased after laparoscopic cholecystectomy and choledocholithotomy, after primary suture of choledocholithiasis, the pressure of bile duct was decreased gradually, and the pressure of bile duct decreased gradually after primary suture of choledocholithiasis, and the pressure of bile duct was decreased gradually after laparoscopic cholecystectomy and choledochotomy. Bile leakage was most likely to occur about 3 days after operation, and the chance of bile leakage was significantly reduced after 7 to 11 days after operation. The primary suture did not increase the biliary tract pressure at discharge, and did not increase the risk of bile leakage after discharge.
【作者單位】： 吉林省前衛(wèi)醫(yī)院普外科;長春醫(yī)學高等�？茖W校;
【基金】：吉林省衛(wèi)計委科研立項(項目編號:7011S032)
【分類號】：R657.4

【相似文獻】

相關期刊論文 前10條

1 周邁;郭晏同;焦崗軍;鐘朝暉;;加貝酯對膽道術后患者膽道壓力及內(nèi)毒素的影響[J];山東醫(yī)藥;2008年25期

2 紀任;倪勇;張敏杰;徐小平;錢文瑾;王成友;;膽道梗阻時膽道壓力對膽汁中頭孢曲松藥物濃度的影響[J];廣東醫(yī)學;2009年12期

3 王曉寧;;腹腔鏡膽總管探查和開腹膽總管探查術后膽道壓力變化的對比研究[J];右江醫(yī)學;2011年01期

4 劉永鋒,何三光,田雨霖,王兆元,于曉光,陳淑珍;惡性膽道梗阻時膽道壓力與肝臟病理改變的臨床基礎研究[J];中國醫(yī)科大學學報;1988年S1期

5 方馳華,景麗華;梗阻性黃疸膽道壓力和門靜脈血流與白細胞介素Ⅱ、補體水平的關系[J];天津醫(yī)藥;1995年12期

6 董米連,施維錦;T管竇道的解剖與臨床意義[J];實用醫(yī)學雜志;2004年08期

7 馮英杰;;急性化膿性膽管炎臨床治療體會[J];中國實用醫(yī)藥;2009年22期

8 曹紅勇，，井清源，江濱;膽道壓力流量測定及動態(tài)膽道造影在膽總管下端殘石診斷中的應用[J];鐵道醫(yī)學;1996年03期

9 秦旭;;膽總管急性梗阻時膽道壓力膽管擴張黃疸三者的關系[J];中國醫(yī)藥指南;2013年04期

10 李學軍;段慧靈;;手術治療急性梗阻性化膿性膽管炎84例報告[J];昌濰醫(yī)學院學報;1987年01期

相關碩士學位論文 前2條

1 顧萍萍;膽道壓力的變化在腹腔高壓導致MODS中的作用研究[D];南京大學;2014年

2 王常元;膽道壓力與門靜脈壓力及腸源性內(nèi)毒素血癥關系的實驗研究[D];南華大學;2012年

本文編號：1552224