摘要
目的探讨胆囊结石合并胆总管结石患者实施胆道镜、腹腔镜联合手术治疗的临床疗效及应用价值。方法选择2016年6月—2021年9月该院接受治疗的胆囊结石合并胆总管结石患者80例为研究对象,根据抛硬币法分为观察组(40例)与对照组(40例)。对照组实施传统开腹手术治疗,观察组采取胆道镜、腹腔镜联合手术治疗。记录两组患者术后恢复用时情况,监测两组患者手术前后炎性因子水平变化,观察且统计两组患者术后并发症发生率。结果观察组手术总用时(130.23±11.16)min长于对照组,术中患者出血量(40.14±5.52)mL少于对照组,差异有统计学意义(t=6.098、28.833,P<0.05)。观察组术后排气、下床及总住院时间均短于对照组,差异有统计学意义(P<0.05)。术前,两组患者炎性因子水平比较,差异无统计学意义(P>0.05);术后,观察组炎性水平均低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率2.50%低于对照组,差异有统计学意义(χ^(2)=8.538,P<0.05)。结论胆囊结石合并胆总管结石患者通过实施胆道镜、腹腔镜联合手术治疗具有确切效果,能够促进患者术后恢复,同时减小手术对患者造成的炎症反应,安全性较佳。
Objective To investigate the clinical efficacy and application value of combined choledochoscopy and laparoscopy in the treatment of patients with cholecystolithiasis complicated with choledocholithiasis.Methods 80 patients with cholecystolithiasis combined with common bile duct stones who were treated in the hospital from June 2016 to September 2021 were selected as the study objects.According to the coin toss method,they were divided into observation group(40 cases)and control group(40 cases).The control group received traditional laparotomy,while the observation group received combined choledochoscopy and laparoscopy.The postoperative recovery time of the patients in each group was recorded,the changes in the levels of inflammatory factors before and after surgery in the two groups were monitored,and the incidence of postoperative complications was observed and counted between two groups.Results The total operation time of the observation group was(130.23±11.16)min longer than that of the control group,and the intraoperative blood loss of the patients was(40.14±5.52)mL less than that of the control group,and the difference was statistically significant(t=6.098,28.833,P<0.05).The postoperative exhaust gas,getting out of bed and total hospital stay in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).Before operation,there was no statistically significant difference in the inflammatory factor levels between the two groups (P>0.05);after operation, the postoperative inflammatory level of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). The total incidence of postoperative complications in the observation group was 2.50% lower than that in the control group, and the difference was statistically significant (χ^(2)=8.538, P<0.05). Conclusion The combined operation of choledochoscopy and laparoscopy for patients with cholecystolithiasis combined with common bile duct stones has definite effect, which can promote the postoperative recovery of patients. At the same time, it can reduce the inflammatory reaction caused by surgery to patients.
作者
李啸
彭朝忠
陈革华
LI Xiao;PENG Chaozhong;CHEN Gehua(Department of General Surgery,Suzhou Wuzhong People's Hospital,Suzhou,Jiangsu Province,215000 China)
出处
《系统医学》
2022年第7期124-127,136,共5页
Systems Medicine
关键词
胆道镜
腹腔镜
胆囊结石
胆总管结石
治疗效果
Choledochoscopy
Laparoscopy
Gallbladder stones
Common bile duct stones
Therapeutic effect
