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腹腔镜胆囊切除术患者住院时间延长的预测因素

Predictive Factors for a Long Hospital Stay in Patients Undergoing Laparoscopic Cholecystectomy.

作者信息

Ko-Iam Wasana, Sandhu Trichak, Paiboonworachat Sahattaya, Pongchairerks Paisal, Chotirosniramit Anon, Chotirosniramit Narain, Chandacham Kamtone, Jirapongcharoenlap Tidarat, Junrungsee Sunhawit

机构信息

Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

Int J Hepatol. 2017;2017:5497936. doi: 10.1155/2017/5497936. Epub 2017 Jan 23.

Abstract

. Although the advantages of laparoscopic cholecystectomy (LC) over open cholecystectomy are immediately obvious and appreciated, several patients need a postoperative hospital stay of more than 24 hours. Thus, the predictive factors for this longer stay need to be investigated. The aim of this study was to identify the causes of a long hospital stay after LC. . This is a retrospective cohort study with 500 successful elective LC patients being included in the analysis. Short hospital stay was defined as being discharged within 24 hours after the operation, whereas long hospital stay was defined as the need for a stay of more than 24 hours after the operation. . Using multivariable analysis, ten independent predictive factors were identified for a long hospital stay. These included patients with cirrhosis, patients with a history of previous acute cholecystitis, cholangitis, or pancreatitis, patients on anticoagulation with warfarin, patients with standard-pressure pneumoperitoneum, patients who had been given metoclopramide as an intraoperative antiemetic drug, patients who had been using abdominal drain, patients who had numeric rating scale for pain > 3, patients with an oral analgesia requirement > 2 doses, complications, and private ward admission. . LC difficulties were important predictive factors for a long hospital stay, as well as medication and operative factors.

摘要

尽管腹腔镜胆囊切除术(LC)相对于开腹胆囊切除术的优势显而易见且广为人知,但仍有部分患者术后住院时间超过24小时。因此,需要对导致这种较长住院时间的预测因素进行研究。本研究的目的是确定LC术后住院时间延长的原因。 这是一项回顾性队列研究,500例择期LC手术成功的患者纳入分析。短住院时间定义为术后24小时内出院,而长住院时间定义为术后需要住院超过24小时。 使用多变量分析,确定了10个导致长住院时间的独立预测因素。这些因素包括肝硬化患者、有既往急性胆囊炎、胆管炎或胰腺炎病史的患者、正在接受华法林抗凝治疗的患者、接受标准压力气腹的患者、术中使用甲氧氯普胺作为止吐药的患者、使用腹腔引流管的患者、疼痛数字评分量表>3的患者、口服镇痛药物需求量>2剂的患者、出现并发症的患者以及入住私人病房的患者。 LC手术难度是导致长住院时间的重要预测因素,药物和手术因素也是如此。

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