Zolinga: Kuphunzira kuthekera ndi chitetezo chogwiritsa ntchito cholecystectomy ya laparoscopic cholecystectomy, ndikupereka chithandizo cha deta pakulimbikitsa kwake kuchipatala.Njira zomwe odwala 97 omwe adachita opaleshoni ya laparoscopic cholecystectomy kuyambira Disembala 2013 mpaka Disembala 2014 adasankhidwa kukhala maphunziro, ndipo adagawidwa m'magulu awiri molingana ndi manambala awo azachipatala, odwala 49 omwe anali ndi manambala odabwitsa azachipatala adasankhidwa monga momwe amawonera. gulu.Odwala makumi anayi ndi asanu ndi atatu omwe ali ndi chiwerengero chofanana anaphatikizidwa mu gulu lolamulira.Malinga ndi magulu, absorbable hemostatic clip ndi titaniyamu kopanira anagwiritsidwa ntchito hemostasis pa ntchito motsatana, ndi zotsatira hemostatic ndi chitetezo deta anayerekezera ndi kusanthula pambuyo opaleshoni.Zotsatira Miyezo yamagazi yamagulu awiriwa inali 18.4% ndi 16.7%, motero.Gulu lowonera linali labwinoko pang'ono kuposa gulu lolamulira, koma panalibe kusiyana kwakukulu (P> 0.05), ndiko kuti, zotsatira za hemostatic zinali zosiyana kwambiri.Kuchuluka kwa zovuta m'magulu awiriwa kunali 12.2% ndi 29.2%, motero.Poyerekeza pakati pa magulu, gulu loyang'anitsitsa linali lochepa kwambiri kuposa gulu lolamulira (P <0.05), ndiko kuti, chitetezo cha gulu loyang'anitsitsa chinali chabwino kwambiri kuposa gulu lolamulira.Mapeto The m'nyumba absorbable hemostatic kopanira ali ubwino wabwino hemostatic zotsatira ndi mkulu chitetezo laparoscopic cholecystectomy, ndipo ndi otetezeka ndi zotheka ntchito kuchipatala.
Intraoperative hemostasis ndi gawo lofunika kwambiri la laparoscopic cholecystectomy, lomwe silimangokhudza mwachindunji kuchita bwino kwa opareshoni, komanso lingawononge moyo wa wodwalayo.Ngakhale chikhalidwe cha titaniyamu chojambula cha hemostasis chimakhala ndi zotsatira zabwino za hemostasis, chimakhalabe m'thupi kwa nthawi yaitali, zomwe zimapangitsa kuti pakhale zovuta zambiri, choncho ziyenera kukonzedwanso.Kupanga ndi kugwiritsa ntchito clipable hemostatic clip kumatha kuchepetsa zovuta zomwe zimachitika chifukwa cha hemostatic operation.Ngakhale kufunika kwake kwatsimikiziridwa ndi maphunziro azachipatala komanso oyenerera, ilibe chithandizo chofunikira cha data pakukwezedwa kwachipatala [1].Kafukufukuyu akufuna kutsimikizira kufunika kwa cholecystectomy laparoscopic cholecystectomy yapakhomo ndikupereka chithandizo cha data pakulimbikitsa kwake.Zomwe zili mkati ndi zomaliza za phunziroli zafotokozedwa mwachidule motere.
1. Deta ndi njira
1.1 General Data chiwerengero cha odwala 97 omwe ali ndi elective laparoscopic cholecystectomy kuyambira December 2013 mpaka December 2014 anasankhidwa monga maphunziro, kuphatikizapo 52 amuna ndi 45 akazi.Kutalika kwa zaka 43-68, ndi zaka (52.6±10.3).Matendawa anali kuyambira miyezi 12 mpaka 49, ndipo pafupifupi (26.5±8.4) miyezi.Panali milandu 48 ya ndulu ndi 49 milandu ya ndulu ya ndulu.Odwala 38 anali ndi mbiri ya opaleshoni ya epigastric.Maphunziro onse adapezeka ndikuthandizidwa ndi opaleshoni yosankha ya laparoscopic, ndipo onsewo adakwaniritsa zofunikira za chilolezo chodziwitsidwa komanso machitidwe azachipatala [2].Maphunzirowa adagawidwa mwachisawawa m'magulu awiri, ndipo panalibe kusiyana kwakukulu pazidziwitso zachipatala pakati pa magulu awiriwa (P> 0.05), kusonyeza kufanana.
1.2 Njira Maphunziro onse adachitidwa opaleshoni ya laparoscopic cholecystectomy ndi unamwino wodutsa.Anthu omwe ali m'gulu loyang'anira adathandizidwa ndi zida za hemostatic (SmAIL absorbable hemostatic ligation clamps zopangidwa ku China), ndipo 1-3 hemostatic clamps idaperekedwa malinga ndi momwe odwala alili.Anthu omwe ali mugulu lowongolera adathandizidwa ndi titaniyamu 1-2 za hemostasis.Opaleshoni ya hemostatic inachitidwa molingana ndi ntchito yachipatala.
1.3 Njira Zopangira Ma Data Mapulogalamu a SPSS18.2 adagwiritsidwa ntchito kusanthula deta yofufuza.Deta yoyezera idawonetsedwa ngati 'X ± S' ndi kuyesa kwa t kudagwiritsidwa ntchito.Deta yowerengera idawonetsedwa ngati X (%) ndipo mayeso a X2 adagwiritsidwa ntchito.Pamene P <0.05, kusiyana kunali kwakukulu.
Zotsatira 2.
2.1 Hemostatic effect Kutaya kwa magazi kwa odwala panthawi ya opaleshoni kunatengedwa ngati kuyesa kwa hemostatic effect, ndipo kuchuluka kwa magazi kunali kosiyana kwambiri ndi zotsatira za hemostatic.Kutaya magazi kwa anthu m'magulu awiriwa kunali 18.4% ndi 16.7% motsatira.Ngakhale kuti gulu lowonera linali labwinoko pang'ono kuposa gulu lolamulira, panalibe kusiyana kwakukulu (X2 = 0.049, P = 0.186> 0.05), ndiko kuti, zotsatira za hemostatic zinali zosiyana kwambiri.
2.2 Chitetezo 15d pambuyo pa opaleshoni, malo a hemostatic clamp adawonedwa ndi b-ultrasound, CT ndi njira zina zowonetsera.Kuchuluka kwa minofu ya liquefaction, calcification ndi ululu pa malowa anagwiritsidwa ntchito monga momwe amawunikira chitetezo, ndipo zochitikazo zinali 12.2% ndi 29.2% motsatira.Gulu loyang'anitsitsa linali lochepa kwambiri kuposa gulu lolamulira (P <0.05), ndiko kuti, chitetezo cha gulu loyang'anitsitsa chinali chabwino kwambiri kuposa gulu lolamulira.Onani nkhani yotsatirayi kuti mudziwe zambiri.
Nthawi yotumiza: Dec-27-2021
