腹腔镜胰十二指肠切除术推广的安全性与可行性分析

发布时间：2018-05-19 00:19

  本文选题：腹腔镜胰十二指肠切除术 + 推广　； 参考：《浙江大学》2017年硕士论文

【摘要】：研究目的探讨腹腔镜胰十二指肠切除术在不同级别中心开展的安全性与可行性,为能否推广胰十二指肠切除术提供一定的参考。研究方法回顾性分析2012年9月至2016年9月期间本团队于浙江大学附属邵逸夫医院和浙江省人民医院及在各个合作医院会诊手术时实施的200例腹腔镜胰十二指肠切除术患者的临床资料,分为本院组(160例)和外院组(40例)。患者各项因素包括:1)一般指标:年龄、性别、BMI、有无合并症、有无腹部手术史等。2)术中相关指标:手术时间、术中出血量、术后是否入住ICU等。3)术后恢复情况:下床活动时间、进食流质时间、是否再次手术、有无术后并发症、术后住院时间等。探究本院组和外院组之间腹腔镜胰十二指肠切除术后的短期结果有无差异。研究结果两组患者的性别、年龄和BMI比较,差异无统计学意义。两组患者术前合并症比较,差异无统计学意义。两组手术时间(364.60minvs379.00min,P0.05)比较,差异无统计学意义。两组患者术中出血量(195.38ml vs 225.68ml,P0.05)比较,差异无统计学意义。两组患者围手术期并发症率(40%vs30%,P0.05)比较,差异无统计学意义;两组患者术后入住ICU率(13.1%vs 22.5%,P0.05)比较,差异无统计学意义。本院组首次下床活动时间比外院组短(1.88dvs2.95d,P0.05),差异有统计学意义。两组术后进食流质时间(4.95dvs5.35d,P0.05)比较,差异无统计学意义。两组术后住院时间(17.61dvs18.92d,P0.05)比较,差异无统计学意义。两组术后平均随访时间(30.4mvs24.5m,P0.05)比较,差异无统计学意义。结论相较于OPD,病人可以从LPD中获益,推广LPD是必要的。在具有充分腹腔镜胰十二指肠切除术手术经验及技术的专家指导下,推广LPD是安全可行的。
[Abstract]:Objective to explore the safety and feasibility of laparoscopic pancreaticoduodenectomy in different centers, and to provide some references for popularizing pancreaticoduodenectomy. Methods from September 2012 to September 2016, 200 cases of laparoscopic pancreaticoduodenectomy performed by our team at run Shaw Hospital, Zhejiang Provincial people's Hospital and various cooperative hospitals were retrospectively analyzed. Clinical data of patients undergoing excision, The patients were divided into our hospital group (n = 160) and the external hospital group (n = 40). Patients' factors include: age, sex, complications, history of abdominal surgery, etc.) Intraoperative related indexes: time of operation, amount of blood lost during operation, admission to ICU after operation, etc. 3) postoperative recovery: time to get out of bed, time to move out of bed, etc. Time of feeding fluid, reoperation, postoperative complications, postoperative hospital stay, etc. To investigate the short-term results of laparoscopic pancreaticoduodenectomy between our hospital group and external hospital group. Results there was no significant difference in sex, age and BMI between the two groups. There was no significant difference in preoperative complications between the two groups. The operative time of the two groups was 364.60 min vs 379.00 min (P0.05), there was no significant difference between the two groups. There was no significant difference in intraoperative bleeding volume (195.38 ml vs 225.68 ml P0.05) between the two groups. There was no significant difference in the rate of postoperative complications between the two groups (40 vs 30 vs P 0.05), but there was no significant difference between the two groups in the ICU rate of 13. 1 vs 22. 5% P 0. 05). The first time of getting out of bed in our hospital group was 1.88 dvs2.95 dago P0.05, the difference was statistically significant. There was no significant difference between the two groups in food intake time (4.95 vs 5.35 d P 0.05). There was no significant difference in postoperative hospitalization time (P 0.05) between the two groups. There was no significant difference between the two groups in the mean follow-up time (30.4 mvs24.5 mp0.05). Conclusion compared with OPD, patients can benefit from LPD, and it is necessary to promote LPD. Under the guidance of full experience and technique of laparoscopic pancreaticoduodenectomy, it is safe and feasible to popularize LPD.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735
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本文编号：1907859