T管测压对腹腔镜胆道手术T管引流术后拔管的指导意义

发布时间：2018-06-16 23:44

本文选题：胆道镜 + 测压　；参考：《中国微创外科杂志》2017年07期

【摘要】：目的通过T管对胆道内压力测定,明确拔管前腹部症状的病因,并探讨T管测压对胆道手术T管引流术后拔管的指导意义。方法 2013年1月~2014年1月,94例胆总管切开取石T管引流术后患者中,存在右上腹各种不适症状32例(症状组),无症状62例(对照组),均通过中心静脉压装置行胆道测压,比较2组胆道压力。结果症状组32例胆道压力(19.85±3.89)cm H_2O,明显高于无症状的对照组[(10.47±3.90)cm H_2O,t=11.055,P=0.000]。结论胆道测压对于腹腔镜下胆总管切开取石T管引流术后拔管有指导意义。对于那些拔管前存在症状的病人,应用胆道测压,压力值高于正常值,可积极行胆道镜检查,进一步明确有无结石。对于经过测压,压力值过高而无明显症状者,应积极行胆道镜进一步检查,防止漏诊。
[Abstract]:Objective to determine the etiology of abdominal symptoms before extubation with T tube and to explore the guiding significance of T tube manometry for extubation after T tube drainage in biliary tract surgery. Methods from January 2013 to January 2014, there were 32 patients with all kinds of discomfort in the right upper abdomen (symptom group, 62 cases without symptoms) (control group, all of them were treated with central venous pressure device), among the 94 patients after choledocholithotomy and T tube drainage, 32 cases had different symptoms in the right upper abdomen. Bile duct pressure was compared between two groups. Results in the symptom group, the biliary tract pressure was 19.85 卤3.89)cm H _ 2O, which was significantly higher than that in the asymptomatic control group [10.47 卤3.90)cm H _ 2O _ T 11.055 P > 0.000]. Conclusion Biliary tract manometry is useful for extubation after laparoscopic choledocholithotomy and T tube drainage. For those patients who had symptoms before extubation, the pressure value was higher than the normal value and the pressure value was higher than the normal value. The choledochoscopy could be performed actively to further determine whether there were stones. For those whose pressure is too high without obvious symptoms, choledochoscopy should be performed to prevent missed diagnosis.
【作者单位】：吉林省前卫医院普外科;长春医学高等专科学校;
【基金】：吉林省卫计委科研立项(项目编号:7011S032)
【分类号】：R657.4

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