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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(wú)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(píng)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www.gydjdsj.org.cn.
【Key words】 Gastrointestinal surgical procedures;Intestinal adhesion;Laparoscopy
腹部外科手術(shù)后約90%的患者會(huì)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(wú)腸梗阻發(fā)作史。
