醫(yī)學論文范文:有開腹手術史行腹腔鏡胃腸手術的經(jīng)驗與技巧

醫(yī)學論文范文:有開腹手術史行腹腔鏡胃腸手術的經(jīng)驗與技巧

【摘要】  目的：探討有開腹手術史的患者行腹腔鏡胃腸手術的可行性與技巧。方法：回顧分析8例有開腹手術史的患者再次行腹腔鏡胃腸手術的臨床資料。結(jié)果：除1例患者因腹腔廣泛粘連中轉(zhuǎn)開腹手術外，其余患者均在腹腔鏡下完成粘連松解及相應的胃腸手術，無手術并發(fā)癥發(fā)生。結(jié)論：有腹部手術史的患者仍可行腹腔鏡胃腸手術，但應做好術前評估及中轉(zhuǎn)開腹的準備

【關鍵詞】  胃腸外科手術；腸粘連；腹腔鏡術

 　The experience and skills of laparoscopic gastroenteric surgery for patients with previous laparotomy QIAN Jun,TANG Li�瞞ing,ZHU Jie,et al.Dept.of Gastrointestinal Surgery,the Second People's Hospital of Changzhou,Nanjing Medical University,Changzhou 213003,China

【Abstract】  Ｏbjective:To discuss the feasibility and skills of laparoscopic gastroenteric surgery for patients who had a previous history of laparotomy.Methods:Laparoscopic gastroenteric operations were performed in eight cases who had a previous history of laparotomy from Jan.2008 to Oct.2008,and the data were analyzed and followed up.Results:The lysis of intestinal adhesion and gastroenteric operations were successfully performed under laparoscopy in seven cases,one case was converted to open surgery because of widely tight adhesion.No post�瞣perative complications occurred.Conclusions:People who had a previous laparotomy still have an opportunity to undertake laparoscopic gastroenteric surgery,but the feasibility should be estimated before operation and the surgeon should have preparation of converting to open surgery醫(yī).學.全.在.線m.jfsoft.net.cn.

【Key words】  Gastrointestinal surgical procedures;Intestinal adhesion;Laparoscopy

腹部外科手術后約90%的患者會發(fā)生腸粘連［1］，腹腔鏡開展早期，此類患者屬手術禁忌證。隨著腹腔鏡技術的普及和臨床經(jīng)驗的積累，腹腔鏡手術適應證逐步擴大。我院2008年1月至11月已為50余例患者行腹腔鏡胃腸手術，其中8例有開腹手術史，7例患者最終順利完成腹腔鏡胃腸手術，效果滿意，現(xiàn)報道如下。

1  資料與方法

1.1  臨床資料  本組8例患者中男3例，女5例，46～72歲，平均54.3歲。既往手術病種：闌尾切除術1例，子宮次全切除術2例，膽囊切除術2例，一側(cè)附件切除術1例，十二指腸球部潰瘍穿孔修補術1例，外傷性腸破裂修補術1例。上次手術時間距此次入院時間8個月～10年，均無腸梗阻發(fā)作史。

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