针刺穿线胆囊悬吊在经脐单孔腹腔镜胆囊切除术中的临床对照研究  

Controlled Clinical Studies Of Transumbilical Single Port Laparoscopic Cholecystectomy With The Needle Threading Gallbladder Suspended

作　　者：李祺 

机构地区：[1]江西省九江市湖口县人民医院,332500

出　　处：《中国医疗前沿》2012年第19期3-4,54,共3页China Healthcare Innovation

基　　金：江西省卫生厅普通科技计划项目(编号:20123194)

摘　　要：目的观察针刺穿线胆囊悬吊与常规经脐单孔腹腔镜胆囊切除术的治疗效果。方法 60例符合入选标准的胆囊结石、胆囊息肉患者,随机分成30例行针刺穿线胆囊悬吊经脐单孔腹腔镜胆囊切除术的观察组,30例行常规经脐单孔腹腔镜胆囊切除术对照组,采用手术时间、术中出血、住院时间、疼痛指数、肩背疼痛、C反应蛋白(C-reactive protein,CRP)、凝血功能指标评价两种手术方法的治疗效果。结果两组患者手术时间、术中出血、住院时间、疼痛指数、肩背疼痛、CRP比较,有显著的统计学差异(P<0.05,P<0.01,P<0.001)。两组患者手术前后凝血指数PT、APTT、INR,纤维溶解指数FIB、D-D检测结果比较,观察组凝血功能正常,与治疗前比没有统计学差异(P>0.05),对照组凝血功能异常,与治疗前比有显著的统计学差异(P<0.05,P<0.01,P<0.001)。结论针刺穿线胆囊悬吊经脐单孔腹腔镜胆囊切除术胆囊三角显露良好,传统器械处理起来简单方便,切口小术后不易察觉起到了美容效果,患者术后凝血功能正常,避免了腹腔镜术后患者静脉、肺栓塞的问题。Objective To observe the therapeutic effect of acupuncture threading gallbladder suspension and conventional Transumbilical single port laparoscopic cholecystectomy. Methods 60 patients with gallbladder stones, gallbladder polyps（met the inclusion criteria）, were randomly divided into the 30 cases（observation group） who were treated by transumbilical single port laparoscopic cholecystectomy with acupuncture threading gallbladder, the 30 cases（control group） were surgeried by transumbilical single port laparoscopic cholecystectomy with the the routine. The operative time, blood loss, hospital stay, pain index, shoulder pain, C-reactive protein（C-reactive protein, CRP）, blood clotting function were obsevered to evaluate the therapeutic effect of the two surgical techniques. Re^alts The operative time, blood loss, hospital stay, pain index, shoulder pain, CRP comparison were a statistically significant difference. In two groups of patients before and after surgery（P〈0.05, P〈0.01, P〈0.001）. The coagulation index PT, APTT, INR, fibrinolytic index FIB, DD test results in observation group were no statistically significant differenceand before and after treatment（P〉0.05）. Athese index in control group were a statistically significant difference（P〈0.05, P〈0.01, P〈0.001）. Conclusion The umbilical single hole laparoscopic cholecystectomy with acupuncture threading gallbladder suspended has the following advantages： gallbladder triangle revealed good, traditional instruments to deal with them is simple and convenient, small incision imperceptible played a cosmetic effect after surgery. The patients with normal coagulation avoid laparoscopic postoperative venous, pulmonary embolism problem.

关 键 词：针刺穿线胆囊悬吊经脐单孔腹腔镜胆囊切除术 常规经脐单孔腹腔镜胆囊切除术 炎性反应 疼痛指数 凝血功能 

分 类 号：R657.4[医药卫生—外科学]