小切口胆管纤维镜取石术与腹腔镜联合纤维胆管镜取石术在保胆取石中的临床比较  

Clinical Comparison of Small Incision Choledochofiberscope Lithotomy with Laparoscopic Resection Jointed Choledochofiberscope Lithotomy to Keep Bile Cyst Stone

作　　者：罗德富[1] 

机构地区：[1]都江堰市人民医院普外科,都江堰611830

出　　处：《中国医药导刊》2014年第1期44-45,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨小切口胆管纤维镜取石术与腹腔镜联合纤维胆管镜取石术对在保胆取石中的临床疗效与安全性。方法:124例普外科收治的结石性胆囊炎患者作为研究对象,其中实验组(n=68)接受小切口纤维胆管镜下取石法治疗,对照组(n=56)接受腹腔镜联合纤维胆管镜取石法治疗。结果:手术时间、手术出血量、术后镇痛率及肠道排气时间组间比较差异无统计学意义(P>0.05),两组组中转开腹率(2.9%vs 16.0%)、结石残留率(1.5%vs 14.3%)比较差异具有统计学意义(x2=6.549,、7.493,P<0.05),实验组高于对照组。此外两组患者总并发症发生率比较差异无统计学意义(P>0.05),但实验组急性胰腺炎、胆管感染发生率少于对照组(5.9%、4.4%vs16.1%、12.5%),胆漏发生率高于对照组(20.6%vs5.4%),差异均有统计学意义(X2=4.776、4.169、7.681,P<0.05)。结论:两种微创的手术方法具有其各自的优势,在治疗方案的选择上应根据患者的实际情况选择合适的方法,降低手术对于患者的创伤,尽可能提高手术的治疗效果。Objective：To compare the clinical efficacy and safety of small incision in the bile ducts fiber lithotomy and laparoscopy combined with fiber choledochoscope stone treatment on the paul gall stone surgery.Methods：124 patients with cholecystitis in our hospital general department were randomly divided into experimental and control groups. Experimental group of 68 patients accepted the small incision fiber bile duct endoscopic stone extraction method,and control group of 56 patients accepted laparoscopy combined with fiber choledochoscope method.Results：Two surgical techniques, operative time, operative bleeding, postoperative analgesia rate and intestinal exhaust time was no significant difference （P〉0.05）.Residual stone rate（2.9%vs 16.0%）and the rconversion to open rate（1.5%vs 14.3%）between the two groups, the differences were statistically significant（X2=6.549、7.493,P〈0.05）.But in the experimental group ,the acute pancreatitis, the incidence of bile duct infection were all more than the control group （5.9%, 4.4%vs 16.1%,12.5%）, the incidence of bile leakage was higher than that of the control group （20.6%vs5.4%）, the differences were statistically significant （X2=4.776,4.169,7.681,P〈0.05）.Conclusion：The two minimally invasive surgical methods have their respective advantages.Choosing the appropriate method should be based on the actual situation of the patient on treatment options, to reduce the trauma of surgery for patients and maximize the therapeutic effect of the surgery.

关 键 词：纤维胆管镜 腹腔镜 微创 胆囊结石 

分 类 号：R657.4[医药卫生—外科学]