双腔T型胆汁回输引流管与普通T型引流管临床应用比较性的研究

发布时间：2018-04-02 14:12

本文选题：胆道手术　切入点：T型管　出处：《吉林大学》2015年硕士论文

【摘要】：目的探讨在胆道手术中采用新型双腔T型胆汁回输引流管与普通T型管在预防患者术后并发症及患者术后恢复情况发生的作用，通过对两种T型管应用的回顾性分析，选择一种更合理的T管引流方式。方法选取2013年6月至2015年2月于吉林大学中日联谊医院新民院区肝胆胰外科54例行胆道手术留置T型管患者的临床资料进行回顾性研究与分析。我们将54例患者随机分为A、B组，每组患者均采取常规开腹胆道手术，A组（n=27）患者为观察组，术中留置新型双腔T型胆汁回输引流管；B组（n=27）患者为对照组，术中留置常规T型管。记录两组患者术后白细胞（WBC）、白蛋白（ALB）、总胆红素（TBIL）等恢复正常时间及术后胆汁丢失量情况、术后补液总量、患者术后住院天数和住院总费用、术后出现并发症、术后拔除T型管时间以及术后残余结石例数等情况。结果选取的54行胆道探查术的患者纳入本项研究范围，两组（A、B)各27名患者，其中A组26例患者胆汁回输管在十二指肠内，1例患者胆汁回输管在胆总管内视为失败，不纳入该组数据统计。观察组术后白细胞（WBC）、白蛋白（ALB）、总胆红素（TBIL）等恢复正常时间各项观察指标均优于对照组(P＜0．05)，具有统计学意义。两组患者术后T管拔除时间对比(P0．05)，不具有统计学意义。两组患者均治愈，无死亡病例。观察组术后并发症发生率为23．3%对照组为65.4%，观察组术后并发症发生率远低于对照组术后并发症发生率，，两组差异有统计学意义(P＜0．05或P0.01）。结论在胆道手术中采用新型双腔T型胆汁回输引流管在预防患者术后并发症（切口感染、肺部感染、腹腔感染、出血、胆汁漏）及患者术后恢复情况，并利于患者术后早期肠内营养，恢复肠道功能较普通T型管有较大的优势。
[Abstract]:PurposeTo explore the role of new type T-type bile drainage tube and common T-tube in preventing postoperative complications and postoperative recovery in patients undergoing biliary tract operation. The application of the two types of T-tube was analyzed retrospectively.Choose a more reasonable T tube drainage method.MethodFrom June 2013 to February 2015, the clinical data of 54 patients with T-tube indwelling in the Department of Hepatobiliary and Pancreatic surgery in Xinmin Hospital of Jilin University were retrospectively studied and analyzed.54 patients were randomly divided into group A (n = 54), group A (n = 27), group A (n = 27), group B (n = 27) and group B (n = 27).The recovery time of WBC, Alb, TBIL, the amount of bile loss, the total amount of fluid rehydration, the days of hospitalization, the total cost of hospitalization, the complications after operation were recorded in the two groups.The time of removing T-tube and the cases of residual stone after operation were analyzed.ResultA total of 54 patients with biliary tract exploration were included in this study, 27 patients in each group were treated as a failure in group A, 26 patients in group A were treated as a failure in the common bile duct, 1 patient with bile duct in duodenum, 1 patient with bile duct in duodenum.Not included in the group of data statistics.The indexes of WBC, Alb, TBIL in the observation group were better than those in the control group (P < 0.05), and there was significant difference between the observation group and the control group (P < 0.05).The patients in both groups were cured and there were no death cases.The incidence of postoperative complications in the observation group was 23.3% in the control group and 65.4% in the control group. The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P < 0.05 or P 0.01).ConclusionTo prevent postoperative complications (incision infection, pulmonary infection, intraperitoneal infection, hemorrhage, bile leakage) and postoperative recovery, a new type of double-lumen T-type bile drainage tube was used in biliary tract surgery to prevent postoperative complications (incision infection, pulmonary infection, abdominal infection, hemorrhage, bile leakage).It is beneficial to early postoperative enteral nutrition and recovery of intestinal function than that of T-tube.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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