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1、医源性胆道损伤24例临床诊治研究[摘要]目的探讨发生医源性胆道损伤的原因、诊治方法,降低医源性胆道损伤的发生率,提高临床治疗效率。方法回顾性分析2006年6月〜2011年12月发生医源性胆道损伤24例患者的临床资料,选取其中12例发病后12h内完成手术的患者为A组,以发病24h后完成治疗的12例患者为B组,并结合相关文献分析发生医源性胆道损伤的常见原因和诊治方法,比较不同时期治疗对患者预后的影响。结果A组患者术后住院时间为(16.5±2.7)d,治疗费用为(21590.5±859.6)元,B组分别为(24.2土4.l)d和(35421.2±1462.2)元,组间
2、比较差异有统计学意义(t=8.857、157.629,P<0.05)oA组患者术后1d和出院时SAS评分分别为(49.20±12.04)分和(34.15±4,82)分;B组分别为(58.20±19.37)分和(42.50±17.24)分,组间比较差异有统计学学意义(t二16.420、13.424,P<0.05)。A组患者术后1d和出院时SDS评分分别为(46.42±11.66)分和(30.42±8.99)分,B组分别为(55.48±11.67)分和(40.17±10,63)分,组间比较差异具有统计学学意义(t=15.897、17.690,P<0.05)。结论早期
3、诊断和治疗胆道损伤,可有效避免二次手术对患者的伤害,改善患者预后。[关键词]胆道损伤;诊断;治疗时机;预后[中图分类号]R657[文献标识码]B[文章编号]1673-7210(2012)07(a)-0149-02Analysisofclinicaldiagnosisandtreatmentof24patientswithiatrogenicbileduetinjuryYANGXulJIANGBo2XIANGHua21.GeneralSurgery,theForthPeople"sHospitalofHuaihuaCity,Hu'nanProvince,Huaih
4、ua418000,China;2.ThePeople"sHospitalofHu"nanProvinee,Hu,nanProvince,Changsha410000,China[Abstract]ObjectiveToinvestigatethecause,diagnosisandtreatmentofiatrogenicbileductinjury,thustoreducetheincidenceofiatrogenicbileduetinjuryandimproveclinicaltreatmentefficiency・MethodsTheclinicald
5、ataof24patientswithiatrogenicbileduetinjuryinJune2006toDecember2011wereretrospectivelyanalyzed.12casesthatcompletedsurgerywithin12hoursaftertheonsetofthediseasewerechosenasgroupAand12casestha/tcompletedsurgerywithin24hoursaftertheonsetofthediseasewerechosenasgroupB,andcombinedwithlit
6、eratureanalysis,thecommoncause,diagnosisandtreatmentmethodsofthediseasewereanalyzedandtheeffectofdifferentperiodsoftreatmentontheprognosisofpatientswerealsoanalyzed・ResuItsIngroupA,patients'postoperativehospitalstaywere(16・5±2.7)daysandthecostoftreatmentwere(21590.5+859.6)yuan,whichw
7、eresignificantlydifferentthanthatofgroupB[(24.2±4.1)daysand(35421.2±1462.2)yuan](t二8.857,157.629,P<0.05).SASscoresaftersurgeryonedayandupondischargewere(49.20±12.04)scoresand(34.15±4.82)scoresingroupA,whichweresignificantlydifferentthanthatofgroupB[(58.20±19.37)scoresand(42.50±17.24)
8、scores](t二16