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“一針法”膽腸吻合術在膽道疾病中的應用

發(fā)布時間:2018-04-16 08:03

  本文選題:一針法 + 膽腸。 參考:《山東大學》2017年碩士論文


【摘要】:目的:評估"一針法"連續(xù)縫合膽腸吻合術在肝膽疾病中的應用和效果。方法:收集2012年1月至2013年12月間山東省立醫(yī)院器官移植肝膽外二科接受膽腸吻合術的214例患者的臨床資料,回顧性分析的上述患者的臨床資料,根據(jù)患者膽腸吻合術式分組為傳統(tǒng)膽腸吻合術組(間斷吻合)和"一針法"膽腸吻合術組。統(tǒng)計兩組患者膽腸吻合時間、術后膽漏、膽系感染、吻合口出血、膽道狹窄并發(fā)癥發(fā)生率差異。結果:214例患者中,100例患者膽腸吻合采取傳統(tǒng)的間斷吻合術式,114例患者采取"一針法"吻合術式。傳統(tǒng)吻合術組平均吻合時間30±2min,"一針法"吻合組時間為7±1.5min,兩組吻合時間存在顯著差異(p0.05),傳統(tǒng)吻合術式組并發(fā)癥發(fā)生率為:9例(9/100,9%)膽漏,21例(21/100,21%)膽系感染,6例(6/100,6%)膽道狹窄,而"一針法"吻合組患者上述并發(fā)癥發(fā)生率分別為:膽漏1例(1/114,0.8%),膽系感染1例(1/114,0.8%),膽道狹窄0例(0/114,0%),兩組患者上述并發(fā)癥存在顯著差異。而膽道出血兩組患者無顯著差異:傳統(tǒng)吻合組1例(1/100,1%),一針法組2例(2/114,1.8%)結論:"一針法"連續(xù)膽腸吻合是一種操作簡便、省時、并發(fā)癥少的手術方式.
[Abstract]:Objective: to evaluate the application and effect of "one-needle" continuous suture choledojejunostomy in patients with hepatobiliary diseases.Methods: the clinical data of 214 patients undergoing choledochojejunostomy from January 2012 to December 2013 were collected and retrospectively analyzed.Patients with choledochojejunostomy were divided into two groups: traditional choledochojejunostomy group (intermittent anastomosis) and "one needle" choledochojejunostomy group.The time of choledochojejunostomy, postoperative bile leakage, biliary tract infection, anastomotic bleeding and biliary stricture complications were compared between the two groups.Results among 214 cases, 100 cases underwent choledochojejunostomy with traditional intermittent anastomosis and 114 cases were treated with "one needle" anastomosis.The mean anastomosis time was 30 鹵2 min in the traditional anastomosis group and 7 鹵1.5 min in the "one needle" anastomosis group. There was a significant difference in anastomosis time between the two groups (p 0.05). The complication rate in the traditional anastomosis group was 9 cases (9 / 100 / 9)) bile leakage in 21 cases (21 / 100%)) biliary tract infection in 6 cases (6 / 1006).In the "one needle" anastomosis group, the incidence of the above complications were as follows: 1 case of bile leakage, 1 case of biliary tract infection, 1 case of biliary tract infection, and 0 case of biliary tract stenosis, respectively. There was a significant difference in the above complications between the two groups.But there was no significant difference between the two groups: one case in the traditional anastomosis group (1 case) and two cases in the one acupuncture group (2 cases). Conclusion: continuous choledochojejunostomy with "one needle method" is a simple, time-saving and less complicated operation method.
【學位授予單位】:山東大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R657.4

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