目的 腹腔镜胆囊切除术中出血是腹腔镜胆囊切除术中转开腹的重要原因之一[1],本文探讨有效预防和处理腹腔镜胆囊切除术中出血的方法.方法 回顾性分析2006年3月至2011年3月太和县中医院普外科收治的胆囊息肉和结石性胆囊炎行腹腔镜胆囊切除术治疗的632个病例.术中发生出血共67例,2例为胆囊动脉主干出血,1例为肝右动脉损伤,其余均为胆囊动脉分支或胆囊肝床出血.结果 除两例术中止血无效及时中转开腹外,余出血病例均得到有效控制完成腹腔镜手术治疗,且术后未出现再出血及其他严重并发症.结论 如腹腔镜胆囊切除术中发生难控制的出血,盲目钳夹或电凝常常是造成更严重并发症的原因[2].如不能有效控制出血,应及时中转开腹.%Objective Bleeding in discussing the Lapacroscopic cholecystectomy resection is that the Lapacroscopic cholecys-tectomy resection transfers the method opening one of abdomen's important cause[1], and having an effect to bleed in the resection taking precautions against and handling the Lapacroscopic cholecystectomy. Methods Recollect nature analysing 632 cases of the gallbladder polypus and calculus cholecystitis that the receives and cures in the department of General surgery-Chinese Traditional Hospital of Taihe County,do the Lapacroscopic cholecystectomy Between March of 2006 and March of 2011. Bleeding 67 examples in total happened in the skill, 2 examples are that the gallbladder arterial main force bleeds, 1 example is liver right arterial injure, the others is that the gallbladder arterial branch or gallbladder liver bed bleeds without exception. Results Except that the futility stanching bleeding among two example skills transits shipment an abdomen open in time, spare time bleeding case is had an effect to accomplish Lapacroscopic cholecystectomy under the control of without exception treat, do not appear at present after the skill to bleed and their his grave complication again. Conclusion That the clip or the electricity curdles if bleed, blind pliers difficult to control happened in the Lapacroscopic cholecystectomy often is the cause bringing about graver complication . If being able to not have an effect to control a bleeding, should transit shipment an abdomen open in time.
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