生长抑素在肝硬化门脉高压症患者LC中应用.docVIP

生长抑素在肝硬化门脉高压症患者LC中应用 　　[摘要] 目的 总结肝硬化门脉高压症患者腹腔镜胆囊切除术中使用生长抑素的经验,为降低此类患者的手术风险提供依据。方法 将42例胆囊结石合并肝硬化门脉高压症患者随机分两组,均行腹腔镜胆囊切除术,其中1组术中使用生长抑素,另1组按常规手术。比较两组手术时间、术中出血量、腹引出血量、术后出血、住院时间等。结果 经t检验,两组患者手术时间、术中出血量、腹引出血量、术后出血、住院时间等均有显著性差异(P0.05)。结论 生长抑素可以有效减少肝硬化患者行腹腔镜胆囊切除术的术中、术后出血,降低手术并发症的发生率。 　　[关键词] 生长抑素; 肝硬化门脉高压症; 腹腔镜胆囊切除术 　　[中图分类号] R575.2 [文献标识码] A [文章编号] 1673-9701(2010)09-123-02 　　 　　Somatostatin in Cirrhotic Patients with Portal Hypertension in the Application of LC 　　SUN Xiaofeng PEI Chengming 　　General Surgery,General Hospital of Lanzhou Petrochemical,Lanzhou 730060,China 　　 　　[Abstract] ObjectiveSummarized 22 cases of liver cirrhosis with portal hypertension in patients with laparoscopic cholecystectomy experience in the use of somatostatin to reduce the risk of such surgery patients. Methods42 cases of gallstone patients with liver cirrhosis with portal hypertension were randomly divided into two groups,underwent laparoscopic cholecystectomy,in which a group of patients the use of somatostatin,another group according to conventional surgery. Patients were compared operative time,blood loss,abdominal leads to blood,postoperative bleeding,hospital stay and other parameters. ResultsThe t test,two groups of patients with operative time,blood loss,abdominal leads to blood,postoperative bleeding,hospitalization time were significantly different(P0.05). ConclusionSomatostatin can be effectively reduced in patients with cirrhosis laparoscopic. 　　[Key words]Somatostatin; Cirrhotic portal hypertension; Laparoscopic cholecystectomy 　　 　　肝硬化门脉高压症(cirrhotic portal hypertension,CPH)是腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的绝对或相对禁忌证,术中易出血,术后并发症发生率明显增高。我们对胆囊结石合并CPH患者行LC时使用生长抑素,观察疗效,比较与常规组的手术风险和并发症的发生率。 　　1 资料与方法 　　1.1 研究对象 　　对2000年1月～2009年6月入院的42例胆囊结石合并CPH患者均行LC治疗,术中使用生长抑素22例为实验组;常规行LC 20例为对照组。其中肝炎后肝硬化33例,酒精性肝硬化8例,自体免疫性肝硬化1例。术中均取肝活检,病理证实均为结节性肝硬化。肝功能Child A级38例,Child B级4例。均为慢性胆囊炎合并胆囊结石,无B超提示萎缩或陶瓷样胆囊。男31例,女11例,年龄28～67岁,平均年龄38岁。随机分组,两组一般资料差异无统计学意义(P0.05),具有可比性。 　　1.2 研究方法