本文選題：腹腔鏡胰十二指腸切除術(shù) + 推廣��； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：研究目的探討腹腔鏡胰十二指腸切除術(shù)在不同級(jí)別中心開展的安全性與可行性,為能否推廣胰十二指腸切除術(shù)提供一定的參考。研究方法回顧性分析2012年9月至2016年9月期間本團(tuán)隊(duì)于浙江大學(xué)附屬邵逸夫醫(yī)院和浙江省人民醫(yī)院及在各個(gè)合作醫(yī)院會(huì)診手術(shù)時(shí)實(shí)施的200例腹腔鏡胰十二指腸切除術(shù)患者的臨床資料,分為本院組(160例)和外院組(40例)。患者各項(xiàng)因素包括:1)一般指標(biāo):年齡、性別、BMI、有無合并癥、有無腹部手術(shù)史等。2)術(shù)中相關(guān)指標(biāo):手術(shù)時(shí)間、術(shù)中出血量、術(shù)后是否入住ICU等。3)術(shù)后恢復(fù)情況:下床活動(dòng)時(shí)間、進(jìn)食流質(zhì)時(shí)間、是否再次手術(shù)、有無術(shù)后并發(fā)癥、術(shù)后住院時(shí)間等。探究本院組和外院組之間腹腔鏡胰十二指腸切除術(shù)后的短期結(jié)果有無差異。研究結(jié)果兩組患者的性別、年齡和BMI比較,差異無統(tǒng)計(jì)學(xué)意義。兩組患者術(shù)前合并癥比較,差異無統(tǒng)計(jì)學(xué)意義。兩組手術(shù)時(shí)間(364.60minvs379.00min,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義。兩組患者術(shù)中出血量(195.38ml vs 225.68ml,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義。兩組患者圍手術(shù)期并發(fā)癥率(40%vs30%,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義;兩組患者術(shù)后入住ICU率(13.1%vs 22.5%,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義。本院組首次下床活動(dòng)時(shí)間比外院組短(1.88dvs2.95d,P0.05),差異有統(tǒng)計(jì)學(xué)意義。兩組術(shù)后進(jìn)食流質(zhì)時(shí)間(4.95dvs5.35d,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義。兩組術(shù)后住院時(shí)間(17.61dvs18.92d,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義。兩組術(shù)后平均隨訪時(shí)間(30.4mvs24.5m,P0.05)比較,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論相較于OPD,病人可以從LPD中獲益,推廣LPD是必要的。在具有充分腹腔鏡胰十二指腸切除術(shù)手術(shù)經(jīng)驗(yàn)及技術(shù)的專家指導(dǎo)下,推廣LPD是安全可行的。
[Abstract]:Objective to explore the safety and feasibility of laparoscopic pancreaticoduodenectomy in different centers, and to provide some references for popularizing pancreaticoduodenectomy. Methods from September 2012 to September 2016, 200 cases of laparoscopic pancreaticoduodenectomy performed by our team at run Shaw Hospital, Zhejiang Provincial people's Hospital and various cooperative hospitals were retrospectively analyzed. Clinical data of patients undergoing excision, The patients were divided into our hospital group (n = 160) and the external hospital group (n = 40). Patients' factors include: age, sex, complications, history of abdominal surgery, etc.) Intraoperative related indexes: time of operation, amount of blood lost during operation, admission to ICU after operation, etc. 3) postoperative recovery: time to get out of bed, time to move out of bed, etc. Time of feeding fluid, reoperation, postoperative complications, postoperative hospital stay, etc. To investigate the short-term results of laparoscopic pancreaticoduodenectomy between our hospital group and external hospital group. Results there was no significant difference in sex, age and BMI between the two groups. There was no significant difference in preoperative complications between the two groups. The operative time of the two groups was 364.60 min vs 379.00 min (P0.05), there was no significant difference between the two groups. There was no significant difference in intraoperative bleeding volume (195.38 ml vs 225.68 ml P0.05) between the two groups. There was no significant difference in the rate of postoperative complications between the two groups (40 vs 30 vs P 0.05), but there was no significant difference between the two groups in the ICU rate of 13. 1 vs 22. 5% P 0. 05). The first time of getting out of bed in our hospital group was 1.88 dvs2.95 dago P0.05, the difference was statistically significant. There was no significant difference between the two groups in food intake time (4.95 vs 5.35 d P 0.05). There was no significant difference in postoperative hospitalization time (P 0.05) between the two groups. There was no significant difference between the two groups in the mean follow-up time (30.4 mvs24.5 mp0.05). Conclusion compared with OPD, patients can benefit from LPD, and it is necessary to promote LPD. Under the guidance of full experience and technique of laparoscopic pancreaticoduodenectomy, it is safe and feasible to popularize LPD.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735
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本文編號(hào)：1907859