摘要
目的探讨腹腔镜再次胆道手术对胆总管结石患者的临床效果及对患者生活质量的影响。方法选取130例具有胆道结石手术史需再次进行手术治疗的胆总管结石患者作为研究对象,依照随机分组法将其分为对照组与研究组,每组65例,分别采用开腹手术与腹腔镜手术,对比2组患者的临床治疗效果、生活质量评分。结果研究组患者术中出血量、胃肠功能恢复时间、疼痛持续时间、住院时间均显著优于对照组(P <0. 05),2组手术时间对比,差异无统计学意义(P> 0. 05);术后14 d,研究组谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TB)指标水平与对照组比较,差异无统计学意义(P> 0. 05),但2组AST、ALT、TB指标水平均显著低于术前(P <0. 05);研究组患者并发症发生率为4. 62%,显著低于对照组47. 69%(P <0. 05);研究组患者术后SF-36量表各生活质量评分显著高于对照组(P <0. 05)。结论采用腹腔镜再次胆道手术治疗胆总管结石患者临床效果显著,具有安全性高、患者创伤小、术后恢复快、并发症少等优点,可显著提高患者生活质量。
Objective To explore the effect of laparoscopic secondary surgery for biliary tract on clinical efficiency and quality of life in patients with choledocholithiasis.Methods A total of choledocholithiasis 130 cases with laparoscopic secondary surgery for biliary tract were selected and randomly divided into control group and research group,with 65 cases in each group.The control group and research group was treated by laparotomy and laparoscopic surgery respectively.Clinical effect and quality of life score were compared between two groups.Results The intraoperative blood loss,recovery time of gastrointestinal function,duration of pain and hospital stay in the research group were significantly better than those in the control group(P<0.05),and there was no significant difference in operation time between the two groups(P>0.05).On the 14 th day after operation,there were no significant differences in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TB)between the two groups(P>0.05),but the levels of AST,ALT and TB in both groups were significantly lower than those before operation(P<0.05).The incidence rate of complications in the research group was 4.62%,which was significantly lower than 47.69%in the control group(P<0.05).The scores of items in SF-36 in the research group were significantly higher than those in the control group(P<0.05).Conclusion Laparoscopic reoperation is effective in treatment of patients with choledocholithiasis,which has the advantages of high safety,small trauma,quick recovery and fewer complications,and it can significantly improve the quality of life of patients.
作者
王贤龙
许全林
WANG Xianlong;XU Quanlin(Surgery Department,Shangnan County Hospital of Traditional Chinese Medicine,Shangluo,Shaanxi,726300;The Second Ward in Department of General Surgery,Xi′an Third Hospital,Xi′an,Shaanxi,710016)
出处
《实用临床医药杂志》
CAS
2020年第4期108-111,共4页
Journal of Clinical Medicine in Practice
关键词
腹腔镜
胆总管结石
再次胆道手术
生活质量
laparoscopy
choledocholithiasis
secondary surgery for biliary tract
quality of life
