摘要
目的对比研究循A-B-D路径改良腹腔镜胆囊切除术(LC)治疗胆囊结石伴急性胆囊炎患者的效果。方法回顾性分析我院普外科收治的150例胆囊结石伴急性胆囊炎患者的临床资料及随访资料,根据治疗方法的不同将其分为对照组(n=75)和观察组(n=75),对照组采用LC,观察组实施A-B-D路径改良LC,比较两组手术一般情况、中转开.腹率、结石清除率、胆管损伤、并发症发生率、术前及术后血清指.标变化、疼痛评分(VAS)。结果观察组手术时间、术中出血量.与对照组差异较小(P>005),观察组术后住.院时间、术后肛门首次排气时间短于对照组(P<005);观察组中转开腹率、结.石清除率与对照组差异较小(P>0.05),观察组胆管损伤明显少于对照组(P<005);与治疗前比较,治疗后两组ALT、WBC、.TBI、hs-CRP均有所升高(P<.005),但观察组低于对照组(P<005.);与治疗.前比较,治疗后两组VAS评分均明显降低,但两组术后VAS评分差异较小(P>005);观察组并发症发生率为533%,低于对照组并发症发生率1667%(P<005)。结论A-B-D路径改良LC能够能有效缩短患者住院时间,减少胆管损伤,改善炎症因子水平,值得临床上进一步推广。
Objective Comparative study on the efficacy of modified laparoscopic cholecystectomy(LC)following the A-B-D pathway in the treatment of patients with gallstones and acute cholecystitis.Methods A retrospective analysis was conducted on the clinical and follow-up data of 150 patients with gallbladder stones and acute cholecystitis admitted to the general surgery department of our hospital.They were divided into a control group(n=75)and an observation group(n=75)based on different treatment methods.The control group received LC,while the observation group received modified A-B-D pathway LC.The general surgical situation,conversion rate to open surgery,stone clearance rate,bile duct injury,incidence of complications,changes in serum indicators before and after surgery,and pain score(VAS)were compared between the two groups.Results There was little difference between the observation group and the control group in operation time and intraoperative bleeding volume(P>0.05),and the observation group had shorter postoperative hospitalization time and the first postoperative anal exhaust time than the control group(P<0.05);The conversion rate to laparotomy and stone removal rate in the observation group were slightly different from those in the control group(P>0.05),and the bile duct injury in the observation group was significantly lower than that in the control group(P<0.05);Compared with before treatment,ALT,WBC,TBI and hs-CRP in the two groups increased after treatment(P<0.05),but the observation group was lower than the control group(P<0.05);Compared with before treatment,the VAS score of the two groups decreased significantly after treatment,but the difference between the two groups was small(P>0.05);The incidence of complications in the observation group was 5.33%,lower than that in the control group(16.67%,P<0.05).Conclusion The A-B-D pathway improved LC can effectively shorten the length of hospital stay of patients,reduce bile duct injury,improve the level of inflammatory factors,and reduce the incidence of complications,which is conducive to postoperative recovery of patients,and is worthy of further clinical promotion.
作者
余海
吴东
项良光
YU Hai;WU Dong;XIANG Liang-guang(General Surgery Department,Fuqing City Hospital,Fuqing 350300,Fujian Province,China)
出处
《罕少疾病杂志》
2024年第5期73-75,共3页
Journal of Rare and Uncommon Diseases
