摘要
目的 研究腹腔镜胆总管切开取石T管引流术治疗肝外胆管结石的效果及对患者生命质量评分的影响.方法 回顾性分析山东省立第三医院肝胆外一科2016年2月-2017年4月收治的肝外胆总管结石患者共计80例,其中男性41例,女性39例,按分层随机化方法进行分组,其中40例行传统开腹胆总管切开取石T管引流手术分为对照组,40例行腹腔镜胆总管切开取石T管引流术分为研究组.比较两组患者手术时间、术中出血量、术后排气时间、术后住院时间以及不良反应的差异.术后1个月及3个月采用门诊或电话方式随访比较生命质量评分.正态分布的计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用x2检验.结果 研究组和对照组手术时间分别为(97.23±10.21) min、(117.52±10.01) min,术中出血量分别为(87.73±10.54) ml、(185.13±11.56) ml,术后排气时间分别为(17.57±2.96)h、(38.44±3.06)h,术后住院时间分别为(7.75±1.21)d、(12.03±3.85)d,研究组各组数据均低于对照组,两组相比其差异有统计学意义(P<0.05).研究组治疗后1个月、3个月的生命质量评分分别为(45.82±3.22)分和(47.29±3.09)分,对照组分别为(32.56±3.29)分和(36.19±3.06)分,研究组明显高于对照组,其差异有统计学意义(P<0.05).两组患者发生胆管狭窄、切口感染、残留结石、胆漏之间的差异无统计学意义(P>0.05).结论 与开腹手术相比,腹腔镜胆总管切开取石T管引流术治疗肝外胆管结石的临床疗效显著,改善生活质量,安全性高,适合临床推广应用.
Objective To observe the effect and quality of life score of laparoscopic choledochotomy and T tube drainage for the patients of extrahepatic bile duct stones.Methods A total of 80 patients with calculus of extrahepatic bile duct in Shandong Provincial Third Hospital from February 2016 to April 2017 were retrospectively analyzed,including 41 males and 39 females,among which,40 patients were treated with laparoscopic choledocholithotomy and T tube drainage(the study group),and the other 40 cases were operated on laparotomy (the control group) by hierarchical randomization grouping.After operation,the time of operation,the amount of bleeding during the operation,the time of postoperative exhaust,the time of postoperative hospitalization and the difference of adverse reactions were observed in the two groups.Follow-up at the end of 1 st and 3th month,quality of life score was compared between the two groups.The measurement data with normal distribution were expressed as mean ± standard deviation (Mean ± SD),comparison between groups were performed using t test.The count data were expressed as rate(%),comparison between groups were performed using chi-square test.Results Comparison of data between the study group and the control group:operation time respectively were (97.23 ± 10.21) min,(117.52 ± 10.01) min,the amount of bleeding respectively were(87.73 ± 10.54) ml,(185.13 ± 11.56) ml,postoperative exhaust time respectively were (17.57± 2.96) h,(38.44 ± 3.06) h and the postoperative hospitalization time were (7.75 ± 1.21) d,(12.03 ± 3.85) d.The data of each group in the study group were lower than those in the control group,and the difference was statistically significant(P < 0.05).The quality of life scores of the 1 months and 3 months after treatment in the study group were (45.82 ± 3.22) scores and (47.29 ± 3.09) scores,the control group were (32.56 ± 3.29) scores and (36.19 ± 3.06) scores.The study group was significantly superior to the control group,and the difference was statistically significant(P < 0.05).The complications of the patients in the study group were not statistically significant between the control group and the control group(P > 0.05).Conclusions Compared with open surgery,laparoscopic choledocholithotomy with T tube drainage has significant clinical effect in the treatment of extrahepatic bile duct stones.It can improve the quality of life and safety,and it is suitable for clinical application.
作者
任广利
袁方水
李晓峰
周敬强
Ren Guangli;Yuan Fangshui;Li Xiaofeng;Zhou Jingqiang(First Department of Hepatobiliary Surgery, Shandong Provincial Third Hospital, Ji'nan 250031,)
出处
《国际外科学杂志》
2019年第6期377-381,共5页
International Journal of Surgery
关键词
腹腔镜
胆总管
胆结石
生命质量评分
T管引流
Laparoscopes
Common bile duct
Cholelithiasis
Quality of life score
T tube drainage
