经阴道内镜下胆囊切除术可行性研究  

Feasibility of transvaginal endoscopic cholecystectomy

作　　者：牛军[1,2] 宋炜[2,4] 樊薇[2,3] 闫明[2,3] 刘恩宇[1,2] 牛卫博[1,2] 彭程[1,2] 林鹏飞[1,2] 

机构地区：[1]山东大学齐鲁医院肝胆外科,济南250012 [2]山东大学齐鲁医院腔镜微创外科研究所,济南250012 [3]山东大学齐鲁医院消化内科,济南250012 [4]山东兖矿集团总医院肝胆外科,济宁273500

出　　处：《中华消化外科杂志》2010年第4期287-289,共3页Chinese Journal of Digestive Surgery

基　　金：中国博士后基金（20090451318）;山东省医药卫生科技发展计划（HZ042）;山东省博士后创新基金（200803073）

摘　　要：目的 探讨经阴道内镜下胆囊切除术的安全性和可行性.方法 回顾性分析2009年5月至11月山东大学齐鲁医院88例行胆囊切除术女性患者的临床资料.其中32例行经阴道内镜下胆囊切除术（NOTES组）,另56例行LC.根据年龄、体质指数、疾病类型、病情严重程度等从56例行LC的患者中选取32例进行逐一配对（LC组）.利用配对t检验比较两种术式术后的疼痛时间、镇痛剂应用剂量、肠蠕动时间、手术时间、下床活动时间、平均住院时间、住院费用等.结果 两组患者均顺利完成胆囊切除术.NOTES组和LC组患者术中出血量、手术时间、疼痛程度、镇痛剂应用剂量、肠蠕动恢复时间、下床活动时间、平均住院时间、治疗费用分别为（5.7±1.5）ml、（76±27）min、2.2±0.6、（10±6）mg、（25±5）h、（9±3）h、（2.1±1.2）d、（1.12±0.34）万元和（13.9±3.1）ml、（38±16）min、6.7±1.5、（28±8）mg、（45±8）h、（26±6）h、（4.3±2.1）d、（1.54±0.18）万元,两组比较,差异有统计学意义（t=5.098,-4.712,2.417,3.203,3.089,4.136,4.786,3.917,P〈0.05）.结论 经阴道内镜下胆囊切除术安全可行,与LC比较有明显优越性.Objective To investigate the feasibility and safety of transvaginal endoscopic cholecystectomy.Methods The clinical data of 88 female patients who underwent cholecystectomy at the Qilu Hospital of Shandong University from May to November, 2009 were retrospectively analysed. Among all the patients, 32 received transvaginal endoscopic cholecystectomy （ NOTES group） and the remaining 56 patients received laparoscopic cholecystectomy （LC）. Thirty-two patients who received LC at the same period were selected （LC group）acccording to age, body mass index, type and severity of disease to conduct a matched case-control study. The differences in time span of postoperative pain, anodyne dose, enterokinesia recovery time, operation time, out-ofbed activity time, average hospital stay and hospitalization expenses between the two groups were compared using the paired t test. Results Cholecystectomies were successfully carried out for all the patients. The intraoperative blood loss, operation time, degree of pain, anodyne doses, enterokinesia recovery time, out-of-bed activity time,average hospital stay and hospitalization expenses were （5.7 ± 1.5 ） ml, （ 76 ± 27 ） minutes, 2.2 ± 0.6, （ 10 ±6） mg, （25±5） hours, （9±3） hours, （2.1 ±1.2） days and （1.12±0.34） ×104 yuan in NOTES group, and they were （ 13.9 ± 3.1 ） ml, （38 ± 16） minutes, 6.7 ± 1.5, （28 ± 8） mg, （45 ± 8） hours, （26 ± 6） hours,（4.3 ± 2.1 ） days and （ 1.54 ± 0.18 ） × 104 yuan in the LC group. There were significant differences between the two groups （t = 5.098, - 4.712, 2.417, 3.203, 3.089, 4.136, 4.786, 3.917, P 〈 0.05 ）. Conclusion Transvaginal endoscopic cholecystectomy is safe and feasible, and it is superior to tranditional LC.

关 键 词：经自然腔道内镜手术 阴道 外科手术 微创性 胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]