腹腔镜胆囊切除术后并发症分布及其影响因素分析

摘要

Objective To explore the distribution and influencing factors of complications after laparo-scopic cholecystectomy ( LC ) , and provide reference for preventing and treating complications after LC. Methods Total of 869 cases of LC were collected from Department of General Surgery in Hainan Nongken General Hospital from Jan. 2008 to Dec. 2013,and these cases were divided into complication group(31 cases) and non-complication group (838 cases) according to the existence of complications. The distribution and risk factors of complications after LC were analyzed. Results The risk factors of complications after LC included operation experience (OR=2. 054,95%CI 1. 390-2. 719),thickness of gallbladder wall (OR=2.591,95%CI1.591-3.590),triangle conglutination of Calot(OR =5.028,95%CI 3.380-6.676),con-glutination between gallbladder and surrounding tissue(OR=3. 967,95%CI 2. 738-5. 196),and complica-tions(OR=4. 043,95%CI 2. 404-5. 682),while drainage(OR=0. 354,95%CI 0. 060-0. 648) was the pro-tective factor. Conclusion The incidence of complications after LC is still high,and there are many risk fac-tors of the complications. So we should adopt prevention measures aimed at these risk factors, in order to reduce the incidence of the complications.%目的：探讨腹腔镜胆囊切除术( LC)后并发症的分布情况及其影响因素,为防治LC术后并发症提供依据。方法选择2008年1月至2013年12月在海南省农垦总医院普外科实施LC的患者869例,依据术后是否发生并发症分为并发症组(31例)和非并发症组(838例)。分析LC术后并发症的分布情况及并发症发生的危险因素。结果影响LC术后并发症发生的危险因素包括手术经验(OR=2．054,95%CI 1．390~2．719)、胆囊壁厚度(OR=2．591,95%CI 1．591~3．590)、Calot三角粘连(OR=5．028,95%CI 3．380~6．676)、胆囊与周围粘连(OR=3．967,95%CI 2．738~5．196)、合并症(OR=4．043,95%CI 2．404~5．682),而放置引流(OR=0．354,95%CI 0．060~0．648)为保护因素。结论 LC后并发症发生率仍较高,且并发症发生的危险因素较多,应针对这些危险因素采取必要的预防措施,从而降低并发症发生率。