摘要
目的 通过临术手术分析诊断腹腔镜胆囊切除术后发生右上腹剧烈腹痛的原因 ,并采取措施降低其发生率。方法 回顾性地分析诊断对照组 138例 L C术后出现的 32例右上腹剧烈腹痛的可能原因。前瞻性地随机将治疗组 186例分为换气引流组 73例 ,换气组 45例 ,引流组 6 8例 ;然后观察分析各组病人术后剧烈腹痛的发生率 ,并与对照组进行比较。结果 对照组剧烈腹痛的发生率为 2 3% ,可能的原因分别是腹腔膈下 CO2 气体酸性刺激 9例 ,肝下积血积液 7例 ,肋软骨受损 5例 ,肠胀气 7例 ,原因不明者 4例。换气引流组、换气组、引流组的术后剧烈腹痛发生率分别是 5 .8% (4例 ) ,13% (6例 ) ,10 .2 % (7例 ) ;对照组与各治疗组间存在显著差异 ,P<0 .0 1。结论 腹腔镜胆囊切除术后出现剧裂腹痛与膈下 CO2 酸性刺激、肝下积气积液、肋软骨损伤、肠胀气等因素有明显关系 ;术前清洁肠道 ,术终时行腹腔换气、置管引流能最大限度地降低术后右上腹剧烈疼痛的发生率 。
Objective To analyze usual causes of continuos uoer-right abdominalgia after LC by clinical means and decrease the morbidity by preventive management.Methods Retrospectively studies possible causes of continuos uper-right abdominalgia in 32 of 132 patients with LC and prospectively study morbidity of 186 patients treated by exchanging abdominal gas and drainage.Their results should be analyzed statistically.Results The morbidity of continuos uoer-right abdominalgia in control group was 23% and their causes could be the acid stimulating of CO2 on diaphragm,hematpcele or effusion under liver,rib injury,gastrointestinal disorder,or unidentified reasons.The morbidity of continuos uooer-right abdominalgia in exchange of the gas and drainage group,the exchange of gas group and the drainage group were 5.8%,13% and 10.2%respectively.There were obvious differences between the groups statistically,P<0.01.Conclusion The causes of continuos uoer-right abdominalgia after LC were acid stimulating of CO2 on diaphragm,Hematocele of effusion under liver,rib injury, gastrointestinal disorder,or unidentified reasons.Cleaning intestine befor operation,gas exchanging and drainage at the end of operation could reduce the symptom morbidity to a minimum.
出处
《肝胆外科杂志》
2000年第5期359-360,共2页
Journal of Hepatobiliary Surgery
