安置心脏起搏器患者行腹腔镜胆囊切除术应注意的问题(附7例报告)
胆囊切除术,,胆囊切除术，腹腔镜；心脏起搏器，人工；病例报告,资料与方法,2结果,3讨论,参考文献：
【摘要】目的：确定安置心脏起搏器患者行腹腔镜胆囊切除术(LC)的可行性及注意问题。方法：采用常规腹腔镜手术设备，术中使用的高频电切器为主要分离切割止血工具，若高频电磁波对起搏器功能影响过大，可采取非电切、电凝法分离、结扎胆囊管及动脉。结果：7例患者均使用高频电切器顺利完成LC术，3例患者在使用高频电切器时对起搏器有轻度干扰，停用后很快恢复正常。结论：安置心脏起搏器患者行LC术是安全、可行的方法，但术前、术中应注意以下几点：(1)了解起搏器性能及抗电磁波干扰能力；(2)术中全面监测心电功能；(3)使用高频电切器持续时间应短；(4)术者应具备娴熟的LC技能，并能在不使用电切器的情况下完成LC。【关键词】 胆囊切除术，腹腔镜；心脏起搏器，人工；病例报告
The technical details in laparoscopic cholecystectomy for patients with pacemaker:with a report of 7 cases
MAO Jingxi，LI Linhai，LIU Cheng，et al.
Kunming General Hospital,Kunming 650032，China
【Abstract】Objective:To assess the feasibility of LC on patients with pacemaker and technical details.Methods:Ordinary laparoscopic instruments were used and electrical radiofrequency cautery was applied for dissection and hemostasis in LC.When remarkable influence on pacemaker indicated,the cystic duct and cystic artery was dissected without application of electrical cautery.Results:LC was successfully completed in 7 patients,In 3 patients,pacemaker was slightly interfered when electrical cautery used and retured to work normally after stopping using cautery.Conclusions:LC is feasible and safe for patients with pacemaker.Attention should be paid to following problems during the procedure:(1)The entity and ability of radiofrequencyproof of pacemaker had to be carefully studied;(2)Realtime monitoring cardiogram is essential;(3)Time for using cautery should be as short as possible;(4)High experience with LC is require for complement of LC without using cautery. ......
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