经脐单孔与常规腹腔镜胆囊切除术的对比研究  

Comparative study of transumbilical single-port laparoscopic cholecystectomy and routine laparoscopic cholecystectomy

作　　者：朱家万[1] 张霞[1] 

机构地区：[1]常德职业技术学院附属第二医院,湖南常德415000

出　　处：《腹腔镜外科杂志》2015年第5期347-350,共4页Journal of Laparoscopic Surgery

基　　金：湖南省科技厅资助课题(编号:2010SK3211)

摘　　要：目的:探讨经脐单孔与常规腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的疗效、相关治疗指标及术后疼痛评分情况。方法:回顾分析2012年10月至2013年12月236例胆囊切除患者的临床资料,其中118例行经脐单孔LC(研究组),118例行常规LC(对照组),对比分析两组患者手术时间、出血量、术后体温、初次下床活动时间、术后进食时间、肛门排气时间、再次下床活动时间、住院时间、术后并发症、术后瘢痕(心理创伤)、术后3个时点的疼痛评分及4个时段的血清CRP、TNF-α、IL-6水平。结果:两组患者术后3个时点的疼痛程度评分、术后再次下床活动时间、肛门排气时间、术后瘢痕(心理创伤)及T2(拔出气管导管即刻)、T4(术后24 h)CRP水平差异均有统计学意义,而手术时间、出血量、术后体温、初次下床活动时间、术后进食时间、住院时间、术后并发症等差异无统计学意义。结论:与常规LC相比,经脐单孔LC肛门排气时间与再次下床活动时间短、T2与T4时CRP水平低、疼痛更轻、腹部美容效果更好。经脐单孔腹腔镜手术创伤更小、安全可行,值得推广。Objective：To explore the treatment outcome, related treatment indicators and postoperative pain assessment of tran- sumbilical single-port laparoscopic cholecystectomy and routine laparoscopic cholecystectomy. Methods：From Oct. 2012 to Dee. 2013, the clinical data of 236 patients who underwent laparoscopic cholecystectomy were analyzed retrospectively. The patients were randomly divided into two groups ： transumbilical single-port laparoscopic cholecystectomy （ observation group, n = 118 ） and routine laparoscopic cholecystectomy （ control group, n = 118 ）. The operation time, blood loss, body temperature, time for first ambulation after surgery, time for dieting, time for anal exhaust, time for the second time of ambulation, hospital stay, postoperative complications, postoperative scar （psychological trauma） ,postoperative pain score of three different points and the level of serum CRP,TNF-αand IL-6 in four different periods were recorded respectively and compared, and the data were statistically analyzed. Results：There were statistically significant differences observed between the two groups in postoperative pain score of three different points ~time for the second time of ambulation, time for anal exhaust,postoperative scar （psychological trauma） and the CRP at T2 （time of pulling out the endotracheal tube） and T4 （24 h after operation）. There were no statistically significant differences between the two groups in operation time, blood loss, body tem- perature, time for first ambulation after surgery, time for dieting, hospital stay, postoperative complications or other indicators. Conclu- sions：Compared with routine laparoscopic cholecystectomy, transumbilical single-port laparoscopic cholecystectomy has shorter time of anal exhaust and second ambulation,lower level of CRP at T2 and T4, less pain and better abdominal cosmetic effect. Transumbilical sin- gle-port laparoscopic cholecystectomy is mini-invasive, safe, feasible and worth promoting.

关 键 词：胆囊切除术 腹腔镜 经脐 单孔 疗效比较研究 

分 类 号：R657.4[医药卫生—外科学]