腹腔镜胆囊切除术术后下肢静脉血栓形成的临床分析(附15例报告)

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后下肢静脉血栓形成的原因、高危因素及防治措施。方法:回顾性分析1 686例LC术后15例发生下肢静脉血栓的临床资料。结果:LC术后出现下肢静脉血栓发生率为0.89%(15/1 686),其中14例经抗凝、中药活血化瘀等对症治疗后症状消失,痊愈出院,1例转院治疗。结论:腹腔镜手术的气腹和特殊体位、麻醉及患者自身的高危因素等都可以导致下肢静脉血栓形成,甚至发生致命性肺栓塞。因此术前正确评估和处理高危因素,术中、术后采取相应的措施,可以预防和减少下肢静脉血栓形成。

Clinical analysis of deep venous thrombosis after laparoscopic cholecystectomy:with a report of 15 cases

Objective:To investigate the reason,high risk factor,prevention and treatment of deep venous thrombosis(DVT) after laparoscopic cholecystectomy(LC).Methods:Clinical data of 15 cases of DVT out of 1 686 cases after LC were summarized retrospectively.Results:The incidence rate of DVT after LC was 0.89%(15/1 686).With symptomatic treatment through anticoagulation,blood flow promotion and blood clot dissolve using Chinese crude drug,14 cases(out of the 15 cases) have their symptom disappeared and discharged with fully recovered;1 case transferred to another hospital for further treatment.Conclusions:All the factors that lead to the DVT even the lethal pulmonary embolism including the pneumoperitoneum,special body position,anaesthesia and the patients' own high risk factor during the laparoscopic operation.Therefore,some measures could be taken to prevent and reduce the DVT including the correct preoperative evaluation,management of high risk factor and adopting corresponding measures during and after the operation.