经脐三孔法腹腔镜急性胆囊炎手术的体会  

Laparoscopic surgery for patients with acute cholecystitis using trans-umbilical three-hole method

作　　者：孙利中 向庆龙 贺永军[2] 

机构地区：[1]江苏省句容市天王中心卫生院外科,212441 [2]江苏省句容市人民医院普外科,212400

出　　处：《中华普外科手术学杂志（电子版）》2015年第5期83-85,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨常规器械经脐三孔法在急性胆囊炎患者行腹腔镜手术中的应用价值。方法收集2012年6月至2014年6月接受择期腹腔镜胆囊切除术的42例急性胆囊炎患者患者,随机分为三孔法组与四孔法组,每组21例。采用SPSS19.0统计软件分析,两组手术时间、术中出血量、肠道功能恢复时间、住院天数、止痛药使用、对患者美容效果的满意度评分,采用t检验。以P<0.05为有统计学差异。结果三孔法组患者的手术时间(38.7±1.2)min长于四孔法组(24.2±1.3)min,两组比较差异有统计学意义(t=2.233,P=0.031);出血量、肠道恢复时间、住院天数及止痛药使用情况两组间的差异无统计学意义;两组患者均没有严重并发症发生;术后由患者本人就腹壁切口进行美容评分,三孔法组患者的评分为(4.62±0.4)分,四孔法组患者的评分为(3.52±0.2)分,两组间的差异有统计学意义(t=2.216;P=0.023)。结论采用常规器械经脐三孔法在急性胆囊炎患者行腹腔镜手术,对部分胆囊炎患者安全可行、美容效果比传统腹腔镜胆囊切除术更好。Objective To explore the value of laparoscopic surgery for patients with acute cholecystitis by using the trans-umbilical three-hole method. Methods From June 2012 to June 2014, 42 patients with acute cholecystitis underwent laparoscopic cholecystectomy. The 42 patients were randomly divided into two groups： three-hole method group （ n = 21 ） and four-hole method group （ n = 21 ）. Clinical data were analyzed by using SPSS19.0 statistical software and Student＇s t test. The data included operation time, intraoperative blood loss, intestinal function recovery time, hospital stay, analgesia medication and satisfaction scoring of cosmetic effect . A P value 〈 0. 05 was considered statistically significant. Results The operation time was longer in the three-hole method group（ 38.7 min ± 1.2 min） than in the four-hole method group （24.2 min ±1.3 min） （ t = 2. 233, P = 0. 031 ）. There were no significant differences between the two groups, in terms of intraoperative blood loss, intestinal recovery time, hospital stay and analgesia medication. There were no serious complications in both groups. Postoperative incision scoring for cosmetology was performed by patients themselves. The score of cosmetology was 4. 62± 0. 4 in the three-hole method group and 3.52 ± 0.2 in the four-hole method group. There was significant difference between the two groups （ t = 2. 216, P 〈 0.05 ）. Conclusion Laparoscopic surgery for patients with acute cholecystitis by using trans-umbilieal the three-hole method is safe and feasible, with better cosmetologic effect than the conventional method.

关 键 词：胆囊炎 急性 腹腔镜检查 对比研究 

分 类 号：R657.41[医药卫生—外科学]