高海拔地区开展腹腔镜胆囊切除术的可行性及注意事项
胆囊切除术,腹腔镜；高海拔,,胆囊切除术，腹腔镜；高海拔,【关键词】胆囊切除术，腹腔镜；高海拔,1资料与方法,2结果,3讨论,参考文献：
【摘要】 目的：探讨高原地区基层医院开展腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的可行性及应注意的若干问题。方法：回顾总结我院LC的开展情况,同时对不同海拔高度的患者术后第1天及第3天的临床表现进行对照统计。结果：完成LC 78例,海拔高度在3 000m以下55例，3 000～4 500m23例,其中急性炎症期(急性胆囊炎、慢性胆囊炎急性发作)16例,慢性萎缩性胆囊炎(结石)3例,慢性胆囊炎(结石、息肉)59例。全组无中转开腹,无并发症,75例行腹腔引流;平均住院6.7d(4～9d),术后平均出院时间4d(2～6d)。结论：高原地区基层医院通过选择合适的病例、腔镜技能的培训、术中仔细配合操作、麻醉监测及妥善处理开展LC是完全可行的。【关键词】 胆囊切除术，腹腔镜；高海拔
The feasibility and announcements of laparoscopic cholecystectomy in areas of high altitude
PU Dongli,SUN Sheng,XIANG Kai,et al.
The 22th Hospital of PLA,Ge'ermu 816000,China
【Abstract】 Objective:To explore the feasibility and announcements of laparoscopic cholecystectomy(LC) in basic level hospitals of high altitude.Methods:Retrospectively analyzed the experiences of carrying out LC in our hospital, and statistically compared the 1d and 3d postoperative clinical manifestation of patients in different elevation.Results:78 LC were performed,among whom 55 cases were completed under 3 000 meters elevation,23 at 3 000 to 4 500 meters elevation,and 16 cases suffered from acute inflammation (acute cholecystitis or chronic cholecystitis acute episode),3 cases were chronic atrophic cholecystitis (cholecystolithiasis), and 59 cases had chronic cholecystitis (cholecystolithiasis or polypus).None of the patients were converted to laparotomy,or suffered from complications.75 patients had abdominal cavity drainage.The mean hospital stay and postoperative hospital stay were 6.7d (49d) and 4d (26d),respectively.Conclusions:By appropriate case choosing,normative laparoscopic training,careful intraoperative cooperation and handling,and intensive anesthetic monitoring,it is feasible to carrying out LC in basic level hospitals of high altitude. ......
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