Abstract: Intego Kwiga uburyo bushoboka n'umutekano byo gukoresha clip ya hemostatike ishobora gukoreshwa muri laparoscopic cholecystectomy, no gutanga amakuru yamakuru yo kuzamura amavuriro.Uburyo abarwayi 97 bose batewe na cholecystectomy ya laparoskopi yatoranijwe kuva mu Kuboza 2013 kugeza Ukuboza 2014 batoranijwe nk'amasomo, kandi bagabanyijwemo amatsinda abiri bakurikije nimero yabo yo kwivuza, hatoranijwe abarwayi 49 bafite nimero idasanzwe yo kwivuza. itsinda.Abarwayi mirongo ine n'umunani bafite umubare uringaniye bashyizwe mu itsinda rishinzwe kugenzura.Nk’uko ayo matsinda abivuga, clip ya hemostatike ikurura na clip ya titanium yakoreshejwe kuri hemostasis mugihe cyo gukora, kandi ingaruka za hemostatike namakuru yumutekano byagereranijwe kandi birasesengurwa nyuma yo kubagwa.Ibisubizo Igipimo cyo kuva amaraso muri ayo matsinda yombi cyari 18.4% na 16.7%.Itsinda ryabarebaga ryarushijeho kuba ryiza kurenza itsinda rishinzwe kugenzura, ariko nta tandukaniro rikomeye ryagaragaye (P> 0.05), ni ukuvuga ko ingaruka ya hemostatike yari itandukanye cyane.Umubare w'ingorane muri ayo matsinda yombi wari 12.2% na 29.2%.Ugereranije hagati yitsinda, itsinda ryabarebaga ryaragabanutse cyane ugereranije nitsinda rishinzwe kugenzura (P <0.05), ni ukuvuga ko umutekano witsinda ryarebaga wari mwiza cyane kuruta itsinda rishinzwe kugenzura.Umwanzuro Clip yo mu rugo ishobora kwinjizwa ifite ibyiza byo kuvura indwara ya hemostatike n'umutekano mwinshi muri laparoskopi cholecystectomy, kandi ifite umutekano kandi birashoboka gukoreshwa mumavuriro.
Intraoperative hemostasis ni igice cyingenzi cya laparoskopi cholecystectomy, ntabwo igira ingaruka gusa kubitsinzi, ahubwo ishobora no guhungabanya ubuzima bwumurwayi.Nubwo clip ya titanium gakondo hemostasis igira ingaruka nziza ya hemostasis, iguma mumubiri igihe kirekire, bigatuma habaho ibibazo byinshi, bityo rero igomba kurushaho kunozwa.Guhimba no gukoresha clip ya hemostatike ishobora gukururwa birashobora kugabanya cyane ingorane ziterwa no kubaga hemostatike.Nubwo agaciro kayo kamaze kwemezwa n’ubuvuzi n’ubuvuzi bufite akamaro, ntikeneye inkunga ikenewe yo kuzamura amavuriro [1].Ubu bushakashatsi bugamije kwemeza agaciro ka clip yo mu rugo yakirwa muri laparoscopic cholecystectomy no gutanga amakuru yo kuyiteza imbere.Ibiri mu myanzuro n'imyanzuro y'ubushakashatsi byasobanuwe muri make ku buryo bukurikira.
1. Amakuru nuburyo
1.1 Amakuru rusange Muri rusange abarwayi 97 barwaye cholecystectomy ya laparoskopi yatoranijwe kuva Ukuboza 2013 kugeza Ukuboza 2014 batoranijwe nk’ubushakashatsi, barimo abagabo 52 n’abagore 45.Imyaka yari hagati yimyaka 43-68, ugereranije (52,6 ± 10.3).Inzira y'indwara yari hagati y'amezi 12 na 49, ugereranije n'amezi (26.5 ± 8.4).Habayeho ibibazo 48 by'amabuye na 49 byatewe na polyp.Abarwayi 38 bagize amateka yo kubaga epigastric.Amasomo yose yarasuzumwe kandi avurwa hakoreshejwe uburyo bwo kubaga laparoskopi, kandi byose byujuje ibyangombwa bisabwa kugira ngo umuntu abyemererwe kandi abone imyitwarire y’ubuvuzi [2].Amasomo yagabanijwemo amatsinda abiri, kandi nta tandukaniro ryibanze ryibanze ryibanze ryamavuriro hagati yaya matsinda yombi (P> 0.05), byerekana kugereranya.
1.2 Uburyo Amasomo yose yabazwe bisanzwe bya laparoskopi cholecystectomy hamwe nabaforomo ba perioperative.Ibintu byari mu itsinda ry’indorerezi byavuwe hamwe na clamps hemostatike (SmAIL absorbable hemostatic ligation clamps yakozwe mu Bushinwa), naho 1-3 hémostatike yatanzwe hakurikijwe imiterere y’abarwayi.Ibintu mumatsinda yo kugenzura bavuwe hamwe na 1-2 ya titanium ya hemostasis.Igikorwa cyihariye cya hemostatike cyakozwe hakurikijwe ibikorwa bisanzwe byubuvuzi.
1.3 Uburyo bwo gutunganya amakuru SPSS18.2 software y'ibarurishamibare yakoreshejwe mu gusesengura amakuru yubushakashatsi.Ibipimo byo gupima byagaragaye nka 'X ± S' kandi t ikizamini cyakoreshejwe.Ibarura ryamakuru ryagaragaye nka X (%) naho X2 ikoreshwa.Iyo P <0.05, itandukaniro ryari rifite akamaro.
Ibisubizo 2.
2.1 Ingaruka ya Hemostatike Igipimo cyo kuva amaraso kubarwayi mugihe cyo kubagwa cyafashwe nkibipimo byo gusuzuma ingaruka ziterwa na hemostatike, kandi umuvuduko wamaraso wagereranijwe ningaruka za hemostatike.Ikigereranyo cyo kuva amaraso mu matsinda yombi cyari 18.4% na 16.7%.Nubwo itsinda ryabarebaga ryarushijeho kuba rito kurenza itsinda rishinzwe kugenzura, nta tandukaniro rikomeye (X2 = 0.049, P = 0.186> 0.05), ni ukuvuga ko ingaruka ya hemostatike yari itandukanye cyane.
2.2 Umutekano 15d nyuma yo kubagwa, aho clamp ya hemostatike yagaragaye na b-ultrasound, CT nubundi buryo bwo gufata amashusho.Ikibazo cyo kwanduza tissue, kubara no kubabara kururu rubuga byakoreshejwe nkibipimo byo gusuzuma umutekano, naho ibyabaye byari 12.2% na 29.2%.Itsinda ryabarebaga ryaragabanutse cyane ugereranije nitsinda rishinzwe kugenzura (P <0.05), ni ukuvuga ko umutekano witsinda ryarebaga wari mwiza cyane ugereranije nitsinda rishinzwe kugenzura.Reba ingingo ikurikira kumakuru yihariye.
Igihe cyo kohereza: Ukuboza-27-2021
