【摘要】　目的　 探討高原地區(qū)腹腔鏡膽囊切除術(shù)（laparoscopic cholecystectomy，LC）患者的特點(diǎn)，以便更好地進(jìn)行圍手術(shù)期處理。　方法　 對2009年2月-2010年5月收治的長期生活在西藏高原地區(qū)的患者（高原組）367例和非高原地區(qū)患者（非高原地區(qū)組）167例的一般資料、術(shù)前診斷、合并癥情況進(jìn)行回顧性分析，兩組患者性別、年齡及病程比較，差異無統(tǒng)計(jì)學(xué)意義（P gt;0.05），有可比性。兩組患者診斷均以膽囊結(jié)石為主，其次為膽囊息肉，診斷構(gòu)成比較，差異無統(tǒng)計(jì)學(xué)意義（P gt;0.05）；兩組患者合并癥比較，高原組患者高血壓、冠心病、血紅蛋白增多癥及竇性心動過緩的發(fā)生率高于非高原地區(qū)組（P lt;0.05）；肺部疾病、肝硬化、糖尿病及腦梗死的發(fā)生率兩組患者比較差異無統(tǒng)計(jì)學(xué)意義（P gt;0.05）。兩組患者均采用常規(guī)LC進(jìn)行治療，對兩組患者術(shù)后臨床結(jié)果、并發(fā)癥等進(jìn)行統(tǒng)計(jì)學(xué)分析。　結(jié)果　 高原組患者手術(shù)中轉(zhuǎn)開腹率（7.1%）高于非高原地區(qū)組（2.4%）患者（P lt;0.05）；高原組患者較非高原地區(qū)組患者住院時(shí)間長、手術(shù)時(shí)間長、術(shù)中出血量多（P lt;0.05）；術(shù)后并發(fā)癥比較差異無統(tǒng)計(jì)學(xué)意義（P gt;0.05）。　結(jié)論　 高原地區(qū)LC患者宜及時(shí)中轉(zhuǎn)開腹，其圍手術(shù)期處理得當(dāng)將有助于減少術(shù)后并發(fā)癥的發(fā)生。
【Abstract】　Objective　 To explore the characteristics of patients undergoing laparoscopic cholecystectomy in highland area, in order to carry out better perioperative management.　Methods　 We collected and analyzed the general information, preoperative diagnosis and complications of 367 patients living in highland area and 167 patients living in inland between February 2009 and May 2010. There was no significant difference between the two groups in sex, age and course of disease (P gt;0.05). Cholecystolithiasis was the main disease followed by gallbladder polyps, and there was no difference between them in the kind of diseases (P gt;0.05). The incidence of hypertension, coronary heart disease, hereditary persistence of fetal hemoglobin and sinus bradycardia was higher in patients in highland area than that in patients in non-highland area (P lt;0.05). There was no significant difference in the incidence of lung disease, liver cirrhosis, diabetes mellitus and cerebral infarction between the two groups (P gt;0.05). Conventional laparoscopic cholecystectomy was conducted in both two groups. Comparative analysis of treatment outcome and postoperative complications was done.　Results　 The rate of conversion from laparoscopic surgery to laparotomy in Tibetan patients (7.1%) was higher than that in patients in non-highland area (2.4%) (P lt;0.05). Hospitalization time, operation time and blood loss in Tibetan patients were significantly higher than those in patients in non-highland area (P lt;0.05), but there was no significant difference in postoperative complications between the two groups of patients (P gt;0.05).　Conclusions　 Laparoscopic cholecystectomy for patients in highlardarea should be converted to laparotomy when necessary. Appropriate perioperative management is helpful in reducing the incidence of postoperative complications.

引用本文： 黃韜,羅彪,劉佳,杜景平. 高原地區(qū)和非高原地區(qū)腹腔鏡膽囊切除術(shù)的比較. 華西醫(yī)學(xué), 2011, 26(10): 1514-1516. doi: 復(fù)制