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[哪些患者在择期腹腔镜胆囊切除术后需要监测实验室检查值?评分能否提供帮助?]

[Which patient needs controls of laboratory values after elective laparoscopic cholecystectomy?-Can a score help?].

作者信息

Fischer L, Kolb G, Segendorf C, Huber B, Watrinet K, Horoba L, Huck B, Schultze D

机构信息

Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland.

出版信息

Chirurg. 2021 Apr;92(4):369-373. doi: 10.1007/s00104-020-01258-9.

Abstract

BACKGROUND

Laparoscopic cholecystectomy is nearly exclusively carried out as an inpatient operation in Germany. The aim of the study was to evaluate for which patients postoperative laboratory control values are necessary.

METHODS

This retrospective analysis included 100 patients who underwent elective laparoscopic cholecystectomy. A scoring and data collection sheet was developed, which enables a risk stratification. Using the scoring system patients can achieve between 3 and 15 points.

RESULTS

In total 100 patients were included in the study. Of the patients 64 (group 1) had between 3 and 8 points, 29 patients (group 2) between 9 and 11 points and 7 patients (group 3) between 12 and 15 points. In comparison to group 1 the C‑reactive protein values as well as the duration of hospital stay were significantly increased in group 2 and group 3 (p > 0.05). In group1 a total of 60 patients (93.7%) were discharged regularly on postoperative days 1-3. In group 2 there were 17 patients (58.6%) who could be discharged with unremarkable blood values and in group 3 there were 3 patients (42.8%). In the total collective hospital discharge without a laboratory control of blood values would have been justified in 80% of the patients.

CONCLUSION

A postoperative control of laboratory blood values is not routinely necessary for patients after elective laparoscopic cholecystectomy with a score <9 points.

摘要

背景

在德国,腹腔镜胆囊切除术几乎都作为住院手术进行。本研究的目的是评估哪些患者术后需要进行实验室检查。

方法

这项回顾性分析纳入了100例行择期腹腔镜胆囊切除术的患者。制定了一份评分和数据收集表,用于进行风险分层。使用该评分系统,患者得分在3至15分之间。

结果

本研究共纳入100例患者。其中64例(第1组)得分在3至8分之间,29例(第2组)得分在9至11分之间,7例(第3组)得分在12至15分之间。与第1组相比,第2组和第3组的C反应蛋白值以及住院时间显著增加(p>0.05)。在第1组中,共有60例患者(93.7%)在术后第1至3天正常出院。在第2组中,有17例患者(58.6%)血液检查结果正常可以出院,在第3组中有3例患者(42.8%)。总体而言,80%的患者不进行血液检查而直接出院是合理的。

结论

对于评分<9分的择期腹腔镜胆囊切除术后患者,术后常规进行实验室血液检查并非必要。

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