腹腔镜胆囊切除术围手术期并存病的处理体会

目的：探讨腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）围手术期并存病的处理.方法：回顾分析LC 1 670例中296例并存病的临床资料,其中高血压136例,冠心病74例,糖尿病86例.经围手术期正确处理后行LC术.结果：术中1例死于严重心率失常,1例术后9d死于恶性高血压,酸碱平衡紊乱,其余手术均获成功.结论：在重视避免手术严重并发症的同时,术前需对患者并存病作出合理评估和治疗,以减少术中并存病引发的不良后果.加强围手术期并存病的处理,对降低LC围手术期病死率有重要意义.

The experience of the treatment for comorbidities in perioperative period of laparoscopic cholecystectomy

Objective:To explore the treatment for comorbidities in perioperative period of laparoscopic cholecystectomy.Methods:The data of 1 670 patients who underwent laparoscopic cholecystectomy were retrospectively analyzed.There were 296 patients with comorbidities including 136 patients with high blood pressure,74 patients with coronary artery disease and 86 patients with diabetes who had been correctly treated before laparoscopic cholecystectomy.Results:One patient died of serious cardiac arrhythmias intraoperatively and one case died of malignant hypertension and disturbance of acid-base balance on ninth day after operation.The remaining patients successfully underwent operation.Conclusions:It is essential to evaluate and improve the patients with comorbidities before operation,in order to reduce harmful consequence incurred by comorbidities.Strengthening the treatment for comorbidities plays an important role in reducing the mortality in periopetative period.