倾向得分匹配法对两种方法治疗胆总管结石的疗效再评价  

Reevaluation of the efficacy of two methods in treatment of choledocholithiasis using propensity score matching

作　　者：别玉坤[1,2] 杨成林[1,2] 曹卫[1,2] 冯以斌 邱伟[1,2] 王宁[1,2] 

机构地区：[1]陕西省安康市中心医院 [2]安康职业技术学院附属医院普通外科,陕西安康725000

出　　处：《中国普通外科杂志》2014年第8期1059-1062,共4页China Journal of General Surgery

摘　　要：目的:再评价腹腔镜胆总管探查术与开腹手术治疗胆总管结石的疗效。方法:收集我院2012年1月—2014年1月手术治疗的92例胆总管结石患者临床资料,其中34例行腹腔镜胆总管探(腹腔镜组),58例行开腹手术(开腹组),采用倾向得分匹配法(PSM)均衡组间混杂因素的影响,比较匹配后两组患者的临床指标。结果:经PSM法成功匹配30对患者,所有基线资料在组间分布均衡。两组患者的手术时间差异无统计学意义(P=0.190),腹腔镜组术中出血量明显少于开腹组,且胃肠功能恢复时间及住院时间也明显短于开腹组,差异均有统计学意义(均P<0.05);两组患者术后并发症发生率差异无统计学意义(P>0.05)。结论:腹腔镜胆总管探查术治疗胆总管结石较开腹手术具有微创,术中失血少,术后恢复快,住院时间短,再评价结果与以往研究一致。Objective： To reevaluate the efficacy of laparoscopic surgery in treatment of common bile duct stones. common bile duct exploration and conventional open Methods： qqae clinical data of 92 patients with common bile duct stones undergoing surgical treatment between January 2012 and January 2014 were collected. Of the patients, 34 cases underwent laparoscopic common bile duct exploration （laparoscopic group）, and the other 58 cases received conventional open surgery （open surgery group）. The clinical parameters between the two groups of patients were compared after adjustment of confounding variables by propensity score matching （PSM）.Results： Thirty pairs of patients were successfully matched by PSM method, and the two matched groups had similar baseline characteristics. There was no statistical difference in operative time between the two groups （P=0.190）; the intraoperative blood loss~ time to gastrointestinal function recovery and length of hospital stay in laparoscopic group were significantly reduced compared with open surgery group （all P〈0.05）; the incidence of postoperative complications of the two groups showed no statistical difference （P〉0.05）. Conclusion： Laparoscopic common bile duct exploration comparing with open surgery for common bile duct stones has the advantages of less intraoperative blood loss, quick postoperative recovery and short length of hospital sta）5 which is in agreement with previous studies.

关 键 词：胆总管结石 碎石术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]