精准腹腔镜下胃旁路手术后并发症及其对策.docVIP

精准腹腔镜下胃旁路手术后并发症及其对策 　　[摘要] 目的 总结精准腹腔镜下胃旁路术（LGBP）后可能出现的并发症及其危险因素、治疗对策。 方法 回顾性分析2010年6月～ 2013年12月我院119例采用精准腹腔镜胃旁路术治疗的患者，详细记录并分析其临床资料。 结果 119例患者出现术后并发症11例（9.2%），其中术后出血3例，肠梗阻2例，短期功能性胃排空障碍6例。其中年龄50岁、糖尿病史、BMI升高为术后并发症的危险因素（OR值分别为1.87、2.14、1.78，P均 0.05），所有患者经对症处理后病情均得到缓解。 结论 腹腔镜下胃旁路手术并发症并不少见，年龄大、合并糖尿病、肥胖的患者更容易出现术后并发症，临床上更应注意此类患者的术后情况，其出现并发症应积极采取对症处理。 　　[关键词] 腹腔镜胃旁路手术;并发症;对策 　　[中图分类号] R616.5 [文献标识码] B [文章编号] 2095-0616（2015）02-151-03 　　The complications and countermeasures of accurate after laparoscopic gastric bypass surgery 　　LIU Jian 　　Department of General Surgery， First Affiliated Hospital of Hunan Chinese Medicine University， Changsha 410007，China 　　[Abstract] Objective To investigate the rate of complications after precise gastric bypass （LGBP） with laparoscopic， discussed the measurements of complications. Methods 119 cases of patients were selected who had precised laparoscopic gastric bypass surgery treatment from June 2010 to December 2013 in our hospital. Results 11 cases （9.2%） of patients accureed postoperative complications， included 3 cases appeared postoperative bleed， 2 case had intestinal obstruction ，and 6 cases short term functional delayed gastric emptying. Patients which age more than 50 years-old， combined diabetes， or with higher BMI score were the risk factors of postoperative complications （OR value were respectively of 1.87，2.14、1.78， P 0.05 ） ， all patients in this study were had remission after taken appropriate treatment. Conclusion Laparoscopic gastric bypass surgery complications are not uncommon， and patients of older， combined diabetes， or with higher BMI score hare more possible to occurred postoperative complications. Such kinds of patients should be pay more attention in clinical work， taken appropriate treatment in the first time Once occurred of complications 　　[Key words] Laparoscopic gastric bypass surgery; Complications; Treatment 　　随着社会发展，难治性肥胖症与2型糖尿病患者的数量日益增加，给临床医生带来新的挑战。随着医学的发展，胃旁路手术为代表的针对肥胖症的外科治疗逐渐开展，如今已发展成治疗肥胖症和代谢性