摘要
目的比较腹腔镜联合胆道镜与开腹手术治疗胆囊结石合并胆总管结石的效果。方法选取胆囊结石合并胆总管结石患者74例。采用随机数字表法分为2组,对照组(n=37)行开腹手术治疗,研究组(n=37)行腹腔镜联合胆道镜微创治疗。比较2组术中指标(术中出血量、术中补液量、手术时间)及术后相关指标(术后VAS疼痛评分、肛门排气时间、胃肠功能恢复时间、住院时间、恢复正常生活时间)、术后并发症发生率、结石复发率。结果研究组术中出血量、术中补液量均显著低于对照组(P <0. 05),2组手术时间比较无显著差异(P> 0. 05)。研究组术后VAS评分显著低于对照组(P <0. 05),肛门排气时间、胃肠功能恢复时间、住院时间、恢复正常生活时间均显著短于对照组(P <0. 05)。研究组术后并发症发生率显著低于对照组(P <0. 05)。随访10个月,2组结石复发率比较无显著差异(P> 0. 05)。结论与开腹手术相比,腹腔镜联合胆道镜微创治疗胆囊结石合并胆总管结石的术中出血量及补液量更少,术后疼痛程度更轻,并发症更少,有利于患者术后恢复。
Objective To compare the effect of laparoscope combined with choledochoscope and laparotomy on the treatment of cholecystolithiasis patients complicated with choledocholithiasis. Methods Totally 74 cholecystolithiasis patients complicated with choledocholithiasis were selected and randomly divided into two groups. Control group （ n =37） underwent laparotomy, while research group （ n =37） underwent laparoscopy combined with choledochoscopy. Intra-operative indexes （intra-operative bleeding, intra-operative transfusion volume, operation time）, postoperative related indexes （postoperative VAS score, anal exhaust time, recovery time of gastrointestinal function, hospitalization, recovery time to normal life）, the incidence rate of postoperative complications and recurrence rate of calculi were compared between two groups. Results The amount of bleeding and intra-operative fluid infusion in the research group were significantly lower than those in the control group （ P 〈0.05）. There was no significant difference in the operation time between the two groups （ P 〉0.05）. The VAS score of the research group was significantly lower than that of the control group （ P 〈 0.05）, and the anal exhaust time, recovery time of gastrointestinal function, hospitalization and recovery time to normal life in the research group were significantly shorter than those in the control group （ P 〈0.05）. The incidence rate of postoperative complications in the research group was significantly lower than that in the control group （ P 〈0.05）. After followup of 10 months, there was no significant difference in recurrence rate of calculi between the two groups （ P 〉0.05）. Conclusion Compared with laparotomy, minimally invasive treatment under laparoscope combined with choledochoscope for cholecystolithiasis complicated with choledocholithiasis has less intra-operative blood loss and fluid infusion, smaller postoperative pain and fewer complications, which is conducive to postoperative recovery of patients.
作者
罗小怀
杜一鸿
LUO Xiaohuai;DU Yihong(Department of Hepatobiliary Surgery,Yangling Demonstration Zone Hospital,Xianyang,Shaanxi,712100;Department of General Surgery,Chang′an Hospital,Xi′an,Shaanxi,710016)
出处
《实用临床医药杂志》
CAS
2018年第22期21-23,共3页
Journal of Clinical Medicine in Practice
关键词
胆囊结石
胆总管结石
腹腔镜
胆道镜
开腹手术
cholecystolithiasis
choledocholithiasis
laparoscope
choledochoscope
laparotomy
