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醫(yī)學(xué)論文范文:有開腹手術(shù)史行腹腔鏡胃腸手術(shù)的經(jīng)驗(yàn)與技巧
【摘要】 目的：探討有開腹手術(shù)史的患者行腹腔鏡胃腸手術(shù)的可行性與技巧。方法：回顧分析8例有開腹手術(shù)史的患者再次行腹腔鏡胃腸手術(shù)的臨床資料。結(jié)果：除1例患者因腹腔廣泛粘連中轉(zhuǎn)開腹手術(shù)外，其余患者均在腹腔鏡下完成粘連松解及相應(yīng)的胃腸手術(shù)，無手術(shù)并發(fā)癥發(fā)生。結(jié)論：有腹部手術(shù)史的患者仍可行腹腔鏡胃腸手術(shù)，但應(yīng)做好術(shù)前評估及中轉(zhuǎn)開腹的準(zhǔn)備
【關(guān)鍵詞】 胃腸外科手術(shù)；腸粘連；腹腔鏡術(shù)
The experience and skills of laparoscopic gastroenteric surgery for patients with previous laparotomy QIAN Jun,TANG Liming,ZHU Jie,et al.Dept.of Gastrointestinal Surgery,the Second People's Hospital of Changzhou,Nanjing Medical University,Changzhou 213003,China
【Abstract】 Ｏbjective:To discuss the feasibility and skills of laparoscopic gastroenteric surgery for patients who had a previous history of laparotomy.Methods:Laparoscopic gastroenteric operations were performed in eight cases who had a previous history of laparotomy from Jan.2008 to Oct.2008,and the data were analyzed and followed up.Results:The lysis of intestinal adhesion and gastroenteric operations were successfully performed under laparoscopy in seven cases,one case was converted to open surgery because of widely tight adhesion.No postoperative complications occurred.Conclusions:People who had a previous laparotomy still have an opportunity to undertake laparoscopic gastroenteric surgery,but the feasibility should be estimated before operation and the surgeon should have preparation of converting to open surgery醫(yī).學(xué).全.在.線m.payment-defi.com.
【Key words】 Gastrointestinal surgical procedures;Intestinal adhesion;Laparoscopy
腹部外科手術(shù)后約90%的患者會發(fā)生腸粘連［1］，腹腔鏡開展早期，此類患者屬手術(shù)禁忌證。隨著腹腔鏡技術(shù)的普及和臨床經(jīng)驗(yàn)的積累，腹腔鏡手術(shù)適應(yīng)證逐步擴(kuò)大。我院2008年1月至11月已為50余例患者行腹腔鏡胃腸手術(shù)，其中8例有開腹手術(shù)史，7例患者最終順利完成腹腔鏡胃腸手術(shù)，效果滿意，現(xiàn)報(bào)道如下。
1 資料與方法
1.1 臨床資料 本組8例患者中男3例，女5例，46～72歲，平均54.3歲。既往手術(shù)病種：闌尾切除術(shù)1例，子宮次全切除術(shù)2例，膽囊切除術(shù)2例，一側(cè)附件切除術(shù)1例，十二指腸球部潰瘍穿孔修補(bǔ)術(shù)1例，外傷性腸破裂修補(bǔ)術(shù)1例。上次手術(shù)時(shí)間距此次入院時(shí)間8個(gè)月～10年，均無腸梗阻發(fā)作史。
