影响腹腔镜胆囊切除术术后住院时间的因素

J. U. Chong, J. H. Lee, Y. Yoon, K. Kwon, J. Cho, S. Kim, Jae Keun Kim, S. Kim, Sae-Byeol Choi, K. Kim
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引用次数: 18

摘要

背景/目的腹腔镜胆囊切除术可减少术后疼痛和恢复时间。然而,一些患者术后住院时间延长。我们的目的是确定影响腹腔镜胆囊切除术后住院时间的因素。方法选取8家医院因胆囊病理原因行腹腔镜胆囊切除术的患者336例,分为术后住院时间≤2 d和≥2 d两组。回顾性分析围手术期因素及患者因素。结果患者中位年龄52岁,急诊手术32例,择期手术304例。围手术期因素的单因素分析显示,手术时间(p<0.001)、围手术期输血(p=0.006)、急诊手术(p<0.001)、急性炎症(p<0.001)和手术部位感染(p=0.041)存在显著差异。单因素分析显示,年龄(p<0.001)、性别(p=0.036)、糖尿病(p=0.011)、术前白蛋白水平(p=0.024)、吸烟(p=0.010)、美国麻醉医师学会评分(p=0.003)有显著差异。在多因素分析中,手术时间(p<0.001)、急诊手术(p<0.001)、年龄(p=0.014)和吸烟(p=0.022)是影响术后住院时间的独立因素。结论手术时间、急诊手术、患者年龄、吸烟对术后住院时间有影响,应成为减少腹腔镜胆囊切除术后住院时间的重点。
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Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy
Backgrounds/Aims Laparoscopic cholecystectomy can reduce postoperative pain and recovery time. However, some patients experience prolonged postoperative hospital stay. We aimed to identify factors influencing the postoperative hospital stay after laparoscopic cholecystectomy. Methods Patients (n=336) undergoing laparoscopic cholecystectomy for gallbladder pathology at 8 hospitals were enrolled and divided into 2 groups: 2 or less and more than 2 days postoperative stay. Perioperative factors and patient factors were retrospectively analyzed. Results The patient population median age was 52 years, and consisted of 32 emergency and 304 elective operations. A univariate analysis of perioperative factors revealed significant differences in operation time (p<0.001), perioperative transfusion (p=0.006), emergency operation (p<0.001), acute inflammation (p<0.001), and surgical site infection (p=0.041). A univariate analysis of patient factors revealed significant differences in age (p<0.001), gender (p=0.036), diabetes mellitus (p=0.011), preoperative albumin level (p=0.024), smoking (p=0.010), and American Society of Anesthesiologists score (p=0.003). In a multivariate analysis, operation time (p<0.001), emergency operation (p<0.001), age (p=0.014), and smoking (p=0.022) were identified as independent factors influencing length of postoperative hospital stay. Conclusions Operation time, emergency operation, patient age, and smoking influenced the postoperative hospital stay and should be the focus of efforts to reduce hospital stay after laparoscopic cholecystectomy.
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