本文選題：膽囊切除術 + 膽囊切除術后綜合征�。� 參考：《濟寧醫(yī)學院》2015年碩士論文

【摘要】：目的:對膽囊切除術后的患者進行調查回訪,了解患者術后的生活質量以及膽囊切除術后綜合征(Postcholecystectomy syndrome,PCS)的發(fā)生現(xiàn)狀,分析膽囊切除術后綜合征發(fā)生的可能原因,明確其危險因素。為膽囊切除術的手術指征提出新觀點,對膽囊疾病的診療規(guī)范進行再思考,為預測膽囊切除術后綜合征的發(fā)生提供理論基礎,為行膽囊切除術患者的術前評估、術后護理、宣教及注意事項提供理論支持。方法:對2013年5月1日至2014年4月30日期間濟寧醫(yī)學院附屬醫(yī)院肝膽外科行膽囊切除術的患者進行隨機抽樣并調查回訪338例,回訪成功316例,其中男性101例,女性215例。將316例患者依據(jù)膽囊切除術后綜合征的診斷標準分為兩組:膽囊切除術后綜合征陽性組和膽囊切除術后綜合征陰性組;采用統(tǒng)一的調查問卷,分別對兩組患者的年齡、性別、血型、體重指數(shù)、飲酒、吸煙、精神焦慮、糖尿病、口服利膽片、飲食習慣、膽囊疾病的類型、手術方式、術前癥狀、病程長短共14個因素進行調查,采用?2分析、logistic回歸分析,研究與膽囊切除術后綜合征的相關性,明確PCS發(fā)生的危險因素。結果:316例患者中發(fā)生PCS者115例,PCS的發(fā)生率為36.39%。上述14項危險因素中,年齡(小于45周歲)、血型(B型)、術前癥狀(有術前癥狀)、精神焦慮(存在焦慮癥狀)4項與PCS的發(fā)生密切相關(P0.05);性別、體重指數(shù)、飲酒、吸煙、糖尿病、服用利膽片、飲食習慣、膽囊疾病的類型、手術方式、病程長短與PCS的發(fā)生無明顯相關性(P0.05)。結論:膽囊切除術后PCS的發(fā)生率為36.39%;年齡、血型、精神焦慮及術前癥狀是PCS發(fā)生的主要危險因素;膽囊切除術的手術指征除現(xiàn)有的標準外,還應考慮患者術后的生活質量等因素。
[Abstract]:Objective: to investigate the quality of life after cholecystectomy and the present situation of postcholecystectomy syndrome (Postcholecystectomy), analyze the possible causes of postcholecystectomy syndrome, and identify the risk factors. In order to provide a theoretical basis for predicting the occurrence of post-cholecystectomy syndrome and to provide preoperative evaluation and postoperative nursing care for patients undergoing cholecystectomy, a new point of view was put forward for the indication of cholecystectomy, and the criteria for diagnosis and treatment of cholecystectomy were reconsidered. Education and attention to provide theoretical support. Methods: from May 1, 2013 to April 30, 2014, the patients undergoing cholecystectomy in the Department of Hepatobiliary surgery, affiliated Hospital of Jining Medical College, were randomly sampled and 338 cases were investigated. 316 cases were successfully visited, including 101 males and 215 females. According to the diagnostic criteria of post-cholecystectomy syndrome, 316 patients were divided into two groups: the positive group of post-cholecystectomy syndrome and the negative group of post-cholecystectomy syndrome. Blood type, body mass index, alcohol consumption, smoking, mental anxiety, diabetes mellitus, oral cholangiopancreatic tablets, dietary habits, types of gallbladder diseases, surgical methods, preoperative symptoms, duration of disease were investigated by logistic regression analysis. To study the correlation with postcholecystectomy syndrome and identify the risk factors of PCS. Results the incidence of PCS in 115 out of 316 patients was 36.39. Among the 14 risk factors mentioned above, age (younger than 45 years), blood type B, preoperative symptoms (with preoperative symptoms and mental anxiety) were closely related to the occurrence of PCS, sex, body mass index, alcohol consumption, smoking, diabetes mellitus, There was no significant correlation between Lidan tablets, dietary habits, types of gallbladder diseases, operative methods, duration of disease and the occurrence of PCS. Conclusion: the incidence of PCS after cholecystectomy is 36.39. Age, blood type, mental anxiety and preoperative symptoms are the main risk factors for the occurrence of PCS. The quality of life after operation should also be considered.
【學位授予單位】：濟寧醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R657.4

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本文編號：1878811