本文選題：膽囊結(jié)石 + 膽總管結(jié)石　； 參考：《山東醫(yī)藥》2017年25期

【摘要】：目的根據(jù)術(shù)前臨床資料建立膽囊結(jié)石合并膽總管結(jié)石患者逆行性胰膽管造影術(shù)(ERCP)術(shù)后行腹腔鏡膽囊切除術(shù)(LC)中轉(zhuǎn)開腹膽囊切除術(shù)的評(píng)分系統(tǒng)。方法選取80例膽囊結(jié)石合并膽總管結(jié)石患者,根據(jù)其ERCP術(shù)后行LC是否中轉(zhuǎn)開腹分為中轉(zhuǎn)組與非中轉(zhuǎn)組,并對(duì)兩組術(shù)前臨床資料進(jìn)行單因素分析,篩選出中轉(zhuǎn)開腹危險(xiǎn)因素,再對(duì)其進(jìn)行Logistic多元回歸分析,得出中轉(zhuǎn)開腹的獨(dú)立危險(xiǎn)因素,再對(duì)該危險(xiǎn)因素進(jìn)行賦值,建立預(yù)測(cè)LC術(shù)中轉(zhuǎn)開腹可能性的評(píng)分系統(tǒng)。結(jié)果術(shù)前1~3 d的CRP(10 mg/L)、血清淀粉酶(125 U/L)、凝血酶原時(shí)間(14 s)、符合SIRS標(biāo)準(zhǔn)為膽囊結(jié)石合并膽總管結(jié)石患者行LC術(shù)中轉(zhuǎn)開腹膽囊切除術(shù)的獨(dú)立危險(xiǎn)因素,并分別被賦值后(CRP10 mg/L為6,≤10為0;血清淀粉酶125 U/L為9,≤125 U/L為0;凝血酶原時(shí)間14 s為8,≤14 s為0;符合SIRS標(biāo)準(zhǔn)為10,不符符合SIRS標(biāo)準(zhǔn)為0),建立中轉(zhuǎn)開腹膽囊切除術(shù)的評(píng)分系統(tǒng)(0分組;1~10分組;11~20分組;21~30分組;30分以上組。相鄰兩組的實(shí)際中轉(zhuǎn)率比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論成功建立了腹腔鏡與術(shù)前十二指腸鏡聯(lián)合治療膽囊結(jié)石合并膽總管結(jié)石EST術(shù)后LC術(shù)中轉(zhuǎn)開腹風(fēng)險(xiǎn)的評(píng)分系統(tǒng)。該系統(tǒng)評(píng)分越高,中轉(zhuǎn)開腹的可能性越大。
[Abstract]:Objective to establish a scoring system for conversion from laparoscopic cholecystectomy (LC) to open cholecystectomy (LC) after retrograde cholangiopancreatography (ERCP) in patients with cholecystolithiasis and choledocholithiasis. Methods Eighty patients with cholecystolithiasis complicated with choledocholithiasis were divided into two groups according to whether or not LC was converted to laparotomy after ERCP. The clinical data of the two groups were analyzed by single factor analysis before operation, and the risk factors of conversion to laparotomy were screened out. The Logistic multiple regression analysis was carried out, and the independent risk factor of conversion to open operation was obtained, and the evaluation system was established to predict the possibility of conversion to open surgery during LC. Results CRP(10 mg / L, serum amylase 125U / L and prothrombin time (14 s / L) were found to be the independent risk factors for patients with cholecystolithiasis complicated with choledocholithiasis during LC operation. The CRP10 mg/L was 6, 鈮，

本文編號(hào)：1952173