肝胆结石术后再次手术原因分析及防治对策.docVIP

肝胆结石术后再次手术原因分析及防治对策 　　[摘要] 目的 探寻肝胆结石术后再次手术的原因以及防治措施。方法 回顾性分析2013年1月―2015年12月该院收治的行肝胆结石手术治疗后因粘连性肠梗阻行再次手术的50患者临床资料，统计分析再次手术的原因，总结预防再次手术的对策。 结果 肝内胆管结石患者引起粘连性肠梗阻原因为腹腔污染、腹腔出血、腹腔损伤的比例分别为：59.38%、25.0%、15.63%；而胆总管结石则分别为55.56%、27.78%、16.67%，组间对比，P0.05；但是在各个原因上，其中腹腔污染原因的占比明显高于另两种原因，P0.05；在再次手术的术后并发症发生率上，胆总管结石患者为5.56%，明显低于肝内胆管结石患者的18.75%，P0.05，差异均有统计学意义。结论 肝胆结石患者首次手术治疗中应制定科学合理的方案，术中谨慎操作，预防肠梗阻的发生，预防再次手术，促进患者早日康复。 　　[关键词] 肝胆结???；再次手术；原因；粘连性肠梗阻；防治 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-0742（2016）08（c）-0105-02 　　Analysis of the Causes of Reoperation and Prevention Measures of Postoperative Biliary Stone 　　ZHU Xue-bin 　　The first Department of general surgery，LianJiang Hospital，Fuzhou，Fujian Province， 350500 China 　　[Abstract] Objective To explore the liver and gallbladder stones after reoperation causes and prevention measures. Methods A retrospective analysis of the clinical data of 88 patients from January 2013 to December 2015 admitted to our hospital for liver gallstones surgery due to adhesive intestinal obstruction for reoperation. Statistical analysis of the cause of the reoperation， summarizes the countermeasures to prevent reoperation. Results The causes of intestinal obstruction in patients with intrahepatic bile duct stones were as follows： 59.38%. 25.0%， and 15.63% respectively；The common bile duct stones were 55.56%. 27.78%， and16.67%respectively， comparison between groups， P 0.05；But in every reason， the proportion of celiac pollution reason was obviously higher than that of the other two reasons， P 0.05； In reoperation rate of postoperative complications， patients with choledocholithiasis was 5.56%， was significantly lower than that of intrahepatic bile duct stones in patients with 18.75%，P 0.05 the difference was statistically significant. Conclusion The scientific and reasonable plan should be made in the first operation for the patients with liver and gallbladder stones. The operation should be careful in the operation， prevent the occurrence of intesti