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急性胆囊炎腹腔镜胆囊切除术量化手术指征探讨
引用本文:胡国治,陈作兵,郭永忠,郑军.急性胆囊炎腹腔镜胆囊切除术量化手术指征探讨[J].腹腔镜外科杂志,2003,8(1):11-13.
作者姓名:胡国治  陈作兵  郭永忠  郑军
作者单位:浙江省诸暨市人民医院,诸暨,311800
摘    要:目的 :探讨并建立一个急性胆囊炎行腹腔镜胆囊切除术 (LC)手术失败的预测模式 ,并确立量化的手术指征。方法 :回顾分析我院 2 2 8例急性胆囊炎LC的诊治经验。结果 :(1)右上腹手术史或发作史 ,临床症状 ,B超表现 ,技术因素在统计学上和LC失败率有相关性 (P <0 0 5 ) ;(2 )急性胆囊炎行LC失败预测方程式 =0 0 5 2 + 0 12 1右上腹部手术史赋值 + 0 0 6 4临床症状赋值 + 0 0 75胆囊B超表现赋值 + 0 182技术因素赋值 (P <0 0 1)。结论 :危险因素术前评分系统PRFSS大于等于 6分组应首选开腹手术。PRFSS是简单 ,实用 ,可行的评分系统。

关 键 词:胆囊炎  胆囊切除术  腹腔镜  预测  危险因素

Study on the quantitative operative indication of laparoscopic cholecystectomy in acute cholecystitis
HU Guo zhi,CHEN Zuo bing,GUO Yong zhong,et al.Study on the quantitative operative indication of laparoscopic cholecystectomy in acute cholecystitis[J].Journal of Laparoscopic Surgery,2003,8(1):11-13.
Authors:HU Guo zhi  CHEN Zuo bing  GUO Yong zhong  
Abstract:Objective:To explore and try to build a predictive model and quantitative operative indication for laparoscopic cholecystectomy(LC) in acute cholecystitis.Methods:The LC experiences on 228 cases of acute cholecystitis were summarized and analyzed retrospectively.Results:(1)The right upper quadrant operation history or recurrence history,clinical symptom, B ultrasound manifestation, skill factor were correlation to the failure rate of LC in acute cholecystitis; (2)The equation for predicting LC in acute cholecystitis=0 052+0 121 right upper quadrant operation history or recurrence history variable+0 064 clinical symptom variable+0 075 B ultrasound manifestation variable+0 182 skill factor variable (P<0.01).Conclusions:The patients with PRFSS≥6 should accept open cholecystectomy instead of LC. PRFSS is a simple, practical and feasible failure rate evaluation system for LC in acute cholecystitis.
Keywords:Holecystitis  Cholecystectomy  laparoscopy  Forecasting  Risk factors
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