腹腔镜下微创碎石术治疗肝胆结石的疗效观察  

Observation of the curative effect of laparoscopic minimally invasive lithotripsy in the treatment of liver and gallbladder stones

作　　者：黄诗栋[1] 

机构地区：[1]深圳市南山区人民医院肝胆外科,深圳518067

出　　处：《中国当代医药》2016年第21期46-49,共4页China Modern Medicine

摘　　要：目的探讨腹腔镜下微创碎石术治疗肝胆结石的临床疗效。方法选取2013年10月～2015年11月本院确诊治疗的140例肝胆结石患者作为研究对象，随机分为腹腔组和常规组，各70例。常规组给予开腹碎石术治疗，腹腔组给予腹腔镜下微创碎石术治疗，采用视觉模拟评分法（VAS）评估疼痛程度．统计分析所有患者的住院、手术、T管拔出、肠功能恢复时间和术中出血量、术后结石取净率、并发症发生率以及术前、术后1d、术后3d、术后5d的疼痛情况。结果腹腔组的住院时间、肠功能恢复时间显著短于常规组，术中出血量显著少于常规组，差异有统计学意义（P〈0．05）。腹腔组的T管拔出时间显著长于常规组。差异有统计学意义（P〈0．05）。腹腔组术后1、3、5d的VAS评分显著低于常规组，差异有统计学意义（P〈0．05）。腹腔组的术后结石取净率显著高于常规组，差异有统计学意义（P〈0．05）。腹腔组的并发症发生率、再手术率显著低于常规组，差异有统计学意义（P〈0．05）。结论腹腔镜下微创碎石术治疗可有效减少肝胆结石患者取石过程中的创伤，减轻患者的痛楚，有利于促进患者身体恢复及减少并发症发生，具有更为良好的疗效和安全性．值得临床推广应用。Objective To explore the clinical effect of laparoscopic minimally invasive lithotripsy in the treatment for liver and gallbladder stones.Methods 140 patients with liver and gallbladder stones from October 2013 to November 2015 in our hospital were selected and randomly divided into the abdominal group and the routine group,70 cases in each group.The routine group was given open lithotripsy treatment,the abdominal group was given laparoscopic minimally invasive lithotripsy treatment.The visual analogue scale （VAS） was used to assess the degree of pain,the length of hospital stay,surgery time,the time of T tube pulled out,intestinal function recovery time,intraoperative bleeding volume, the incidence rate of postoperative stones from the net and complication incidence,the pain situation before operation, 1 day after operation,3 days after operation,5 days after operation in the two groups was statistical analyzed.Results The length of hospital stay and recovery time of bowel function in the abdominal group was shorter than that in the routine group,the amount of blood loss in the abdominal group was less than that in the routine group,with significant difference （P〈0.05）.The T tube extubation time in the abdominal group was longer than that in the routine group,with significant difference （P〈0.05）.The VAS score after operation for 1,3,5 days in the abdominal group was lower than that in the conventional group,with significant difference （P〈0.05）.The rate of stone net in the abdominal group was higher than that in the routine group,with significant difference （P〈0.05）.The incidence rate of complication and reoperation rate in the abdominal group wasy lower than that in the routine group,with significant difference （P〈0.05）.Conclusion Laparoscopic minimally invasive lithotripsy treatment can effectively reduce the stones in patients with liver and gallbladder stones in the process of wound,it can reduce the pain of patients,promote patients recovery and reduce complications,it has b

关 键 词：腹腔镜下微创碎石术 肝胆结石 疗效 安全性 

分 类 号：R657.42[医药卫生—外科学]