经脐单孔腹腔镜胆囊切除术的临床对照研究  

Comparative Study on Transumbflical Single Port Laparoscopic Cholecystectomy and Traditional Laparoscopic Choleeystectomy

作　　者：罗礼君[1] 祖存[2] 

机构地区：[1]成都市第二人民医院麻醉科,四川成都610017 [2]中国人民解放军成都军区机关医院外一科,四川成都610011

出　　处：《昆明医科大学学报》2015年第3期102-104,109,共4页Journal of Kunming Medical University

基　　金：成都军区十二五课题基金资助项目(C14053)

摘　　要：目的比较经脐单孔腹腔镜胆囊切除术,在有气腹和无气腹条件下与传统腹腔镜胆囊切除手术的差别,探讨经脐单孔腹腔镜胆囊切除手术的可行性和安全性.方法对成都市第二人民医院2013年10月至2014年5月收治的l80例胆囊炎病例,按照随机原则分为常规腹腔镜组(60例)、单孔腹腔镜有气腹组(60例)和单孔腹腔镜无气腹组(60例)对3组的手术时间、术中出血量、肠道功能恢复时间、住院时间、并发症、术后切口和腰背部疼痛评分、C-反应蛋白水平、患者满意度评分进行比较.结果单孔腹腔镜组(有气腹和无气腹)比传统腹腔镜组的术中出血量少、术后伤口疼痛评分低(P<0.05);在无气腹条件下单孔腹腔镜组的胃肠道功能恢复时间更短、术后C-反应蛋白更低、并发症发生率更低(P<0.05).结论单孔腹腔镜胆囊切除术比传统腹腔镜胆囊切除术组,能够减少术中出血、减轻术后疼痛;且在无气腹条件下能够减轻术后应急反应,减少术后不良反应和并发症,更有利于术后恢复、具有更高的患者满意度.是值得临床推广的一种手术方法.Objective To analyze the clinical effect and safety of transumbilical single-port laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy.Methods Sixty patients received transumbilical single port laparoscopic cholecystectomy（60 case）,transumbilical single-port with pneumoperitoneal laparoscopic cholecystectomy group（60 cases） and transumbilical single-port with gasless laparoscopic cholecystectomy group（60 cases） from October 2013 to May 2014 were included in the study. The clinical data were retrospectively analyzed. The operative time,intra-operative blood loss, postoperative intestinal function recovery time,length of hospital stay,complications,postoperative wound and back pain score, C-reactive protein levels and satisfaction scores were compared between three groups. Results The transumbilical single-port laparoscopic cholecystectom group（pneumoperitoneum and gasless） had less blood loss than traditional laparoscopic group, postoperative wound pain score was lower（P〈 0.05）. Compared with traditional laparoscopic cholecystectomy,transumbilical single-port with gasless laparoscopic cholecystectomy had shorter postoperative intestinal function recovery time,the less postoperative C-reactive protein level, a lower incidence of complications（P 〈0.05）. Conclusion Compared with traditional laparoscopic cholecystectomy, the transumbilical single-port laparoscopic cholecystectom has less blood loss and postoperative wound and back pain under, and transumbilical single-port with gasless laparoscopic cholecystectomy has advantages of less postoperative adverse reactions and complications postoperative pain, faster recovery, higher patient satisfaction, so it is a safe, feasible and more minimally invasive surgery.

关 键 词：胆囊切除术 腹腔镜 经脐 单孔 无气腹 

分 类 号：R657.41[医药卫生—外科学]