胆囊切除术后综合征现状调查及原因分析

发布时间：2018-05-12 13:35

本文选题：胆囊切除术 + 胆囊切除术后综合征　；参考：《济宁医学院》2015年硕士论文

【摘要】：目的:对胆囊切除术后的患者进行调查回访,了解患者术后的生活质量以及胆囊切除术后综合征(Postcholecystectomy syndrome,PCS)的发生现状,分析胆囊切除术后综合征发生的可能原因,明确其危险因素。为胆囊切除术的手术指征提出新观点,对胆囊疾病的诊疗规范进行再思考,为预测胆囊切除术后综合征的发生提供理论基础,为行胆囊切除术患者的术前评估、术后护理、宣教及注意事项提供理论支持。方法:对2013年5月1日至2014年4月30日期间济宁医学院附属医院肝胆外科行胆囊切除术的患者进行随机抽样并调查回访338例,回访成功316例,其中男性101例,女性215例。将316例患者依据胆囊切除术后综合征的诊断标准分为两组:胆囊切除术后综合征阳性组和胆囊切除术后综合征阴性组;采用统一的调查问卷,分别对两组患者的年龄、性别、血型、体重指数、饮酒、吸烟、精神焦虑、糖尿病、口服利胆片、饮食习惯、胆囊疾病的类型、手术方式、术前症状、病程长短共14个因素进行调查,采用?2分析、logistic回归分析,研究与胆囊切除术后综合征的相关性,明确PCS发生的危险因素。结果:316例患者中发生PCS者115例,PCS的发生率为36.39%。上述14项危险因素中,年龄(小于45周岁)、血型(B型)、术前症状(有术前症状)、精神焦虑(存在焦虑症状)4项与PCS的发生密切相关(P0.05);性别、体重指数、饮酒、吸烟、糖尿病、服用利胆片、饮食习惯、胆囊疾病的类型、手术方式、病程长短与PCS的发生无明显相关性(P0.05)。结论:胆囊切除术后PCS的发生率为36.39%;年龄、血型、精神焦虑及术前症状是PCS发生的主要危险因素;胆囊切除术的手术指征除现有的标准外,还应考虑患者术后的生活质量等因素。
[Abstract]:Objective: to investigate the quality of life after cholecystectomy and the present situation of postcholecystectomy syndrome (Postcholecystectomy), analyze the possible causes of postcholecystectomy syndrome, and identify the risk factors. In order to provide a theoretical basis for predicting the occurrence of post-cholecystectomy syndrome and to provide preoperative evaluation and postoperative nursing care for patients undergoing cholecystectomy, a new point of view was put forward for the indication of cholecystectomy, and the criteria for diagnosis and treatment of cholecystectomy were reconsidered. Education and attention to provide theoretical support. Methods: from May 1, 2013 to April 30, 2014, the patients undergoing cholecystectomy in the Department of Hepatobiliary surgery, affiliated Hospital of Jining Medical College, were randomly sampled and 338 cases were investigated. 316 cases were successfully visited, including 101 males and 215 females. According to the diagnostic criteria of post-cholecystectomy syndrome, 316 patients were divided into two groups: the positive group of post-cholecystectomy syndrome and the negative group of post-cholecystectomy syndrome. Blood type, body mass index, alcohol consumption, smoking, mental anxiety, diabetes mellitus, oral cholangiopancreatic tablets, dietary habits, types of gallbladder diseases, surgical methods, preoperative symptoms, duration of disease were investigated by logistic regression analysis. To study the correlation with postcholecystectomy syndrome and identify the risk factors of PCS. Results the incidence of PCS in 115 out of 316 patients was 36.39. Among the 14 risk factors mentioned above, age (younger than 45 years), blood type B, preoperative symptoms (with preoperative symptoms and mental anxiety) were closely related to the occurrence of PCS, sex, body mass index, alcohol consumption, smoking, diabetes mellitus, There was no significant correlation between Lidan tablets, dietary habits, types of gallbladder diseases, operative methods, duration of disease and the occurrence of PCS. Conclusion: the incidence of PCS after cholecystectomy is 36.39. Age, blood type, mental anxiety and preoperative symptoms are the main risk factors for the occurrence of PCS. The quality of life after operation should also be considered.
【学位授予单位】：济宁医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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