生物蛋白胶在腹腔镜胆囊切除术中应用.docVIP

生物蛋白胶在腹腔镜胆囊切除术中应用 　　摘 要 目的：探讨生物蛋白胶在腹腔镜胆囊切除术中的应用价值。方法：选择行腹腔镜胆囊切除术的患者80例，按入院次序随机分成观察组和对照组各40例，对照组作常规腹腔镜胆囊切除术，观察组按对照组手术方法完成后在胆囊床喷涂生物蛋白胶，比较两组术后引流量、拨管时间、胆瘘发生率、胆粘连发生率、过敏反应及平均住院天数。结果：观察组未发生过敏反应；其术后引流量10.2±5.5ml，显著低于对照组的23.6±9.8ml（P＜0.01）。观察组无胆瘘及肠粘连发生；对照组胆瘘2例（2/40），均经持续腹腔引流后痊愈.对照组术后胆粘连2例（2/40），均经非手术治疗后好转，两组并发症比较，差异有统计学意义（P＜0.05），观察组拨管时间22.3±2.2小时，显著低于对照组的41.9±9.6小时（P＜0.01），观察组平均住院天数5.1±0.8天，显著低于对照组的7.4±0.8天（P＜0.01）。结论：生物蛋白胶应用于腹腔镜胆囊切除术中，在封闭创面、促进组织愈合、预防胆瘘及肠粘连等方面的效果确切，且无不良反应，值得临床推广。 　　关键词 腹腔镜胆囊切除术中 生物蛋白胶 　　 　　Abstract Objective:Td imvestigate the feasibility of biomedical fibrin glue in laparoscopic cholecystectomy.Methods:A total of 80 patients with laparoscopic cholecystectomy were randomly divided into two groups（40 in each group）.Biomedical fibin glue was used in treatment group,and routine treatment wsa used in contrlp group.The total volume of drainage afrer operation,rate of bile fistula and adhesions,allergy reaction,time,of drainage tube removel,and average hospital stay time were observed in both groups.Results:There wsa no allergic reaction in treatment group.Total volume of drainage in treatment group wsa（10.2±5.5）ml,and（23.6±9.8）ml in control group,with a significant difference between the two groups（P＜0.01）.Two fistula Occurred and Two adhesions in control group and none in treatment group（P＜0.05）.Time of drainage tube removal was （22.3±2.2）h in treatment group,and（41.9±9.6）h in control group（P＜0.01）.Average hospital stay time wsa（5.1±0.8）d in treatment group,and （7.4±0.8）d in control group（P＜0.01）.Conclusions:Use of biomedical fibrin glue has a difinite effect on laparoscopic cholecystctomy;it can seal the injured site、promote organiza tion healing and prevent bile fistula and intestinal adhesions,There are no allergic reactions associated wich its use. 　　Key WordsLaparoscopic cholecystectony;Biomedical fibrin glue 　　腹腔镜胆囊切除术（Laparoscopic cholecystectomy，Lc）已成为治疗胆囊良性疾病的金标准［1］，其优点在于创伤小、出血少、全身反应轻、疼痛轻、恢复快［2］。除了肝外胆管损伤，内脏损伤和血管损伤是腹腔镜胆囊切除术的致命并发症外［3］，LC患者还可能出现胆囊床