腹腔镜胆总管探查术治疗复杂性肝胆管结石的安全性及对患者生存质量的影响  

The Safety of Laparoscopic Exploration of Common Bile Duct Treating Complex Hepatolithiasis and the Impact on Quality of Life of the Patients

作　　者：唐寒秋[1] 李晓涛[1] 龙雪艳 

机构地区：[1]汉中市中心医院肝胆外科,陕西汉中723000

出　　处：《医学综述》2016年第20期4143-4145,共3页Medical Recapitulate

摘　　要：目的探讨腹腔镜胆总管探查术治疗复杂性肝胆管结石的安全性及其对患者生存质量的影响。方法选择2012年3月至2015年4月汉中市中心医院接诊的60例复杂性肝胆管结石患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组30例。观察组给予腹腔镜胆总管探查术,对照组实施开腹探查术,比较两组患者的手术时间、住院时间、术后排气时间、生存质量评分、并发症发生率以及复发率。结果观察组患者的手术时间、住院时间以及术后肛门排气时间均短于对照组[(159.0±25.8)min比(212.0±38.4)min、(11.5±2.3)d比(16.0±5.4)d、(20.0±3.6)h比(29.4±7.2)h],差异有统计学意义(P<0.01);观察组患者术中出血量明显少于对照组[(55.4±9.3)m L比(84.8±18.8)m L],生活质量评分明显高于对照组[(123.2±3.0)分比(109.3±5.6)分],住院费用显著低于对照组[(8233.6±288.8)元比(9256.8±477.3)元],差异有统计学意义(P<0.01)。观察组患者结石复发率为0.00%,术后并发症发生率为3.33%;对照组结石复发为16.67%,并发症发生率为23.33%,两组比较差异有统计学意义(P<0.05)。结论腹腔镜胆总管探查术治疗复杂性肝胆管结石治疗的效果良好,不仅可以缩短手术时间、减少术中出血量,且能提高患者的生存质量。Objective To study the safety of laparoscopic common bile duct exploration treating complex hepatolithiasis and the impact on quality of life of the patients. Methods Sixty patients with complex hepa- tolithiasis in Hanzhong Central Hospital from Mar. 2012 to Apr. 2015 were included in the study. According to the random number table method, the patients were divided into a control group and an observation group, 30 patients in each group. The observation group received laparoscopic common bile duct exploration, while the control group received exploratory laparotomy. The operation time, hospitalization time, postoperative exhaust time, quality of life score, complication rate and recurrence rate of the two groups were compared. Results The operative time, hospital stay and anal exhaust time of the observation group were shorter than the cantml goup[（159.0±25.8） rain vs （212.0 ±38.4） min, （11.5 ±2.3） d vs （16.0 ±5.4） d, （20. 0 ± 3.6 ） h vs （ 29. 4± 7.2 ） h ], with statistically significant differences （ P 〈 0. 01 ） ; blood loss of he observation group was significantly lower than the control group [ （55.4 ± 9. 3 ） mL vs （84. 8 ± 18.8 ） mL], the quality of life score was significantly higher than the control group[ （ 123.2 ± 3.0 ） scores vs （ 109. 3 ± 5.6） scores], hospital costs of observation group was significantly lower than control group [ （8233.6 ± 288.8） yuan vs （9256. 8 ± 477.3 ） yuan], with statistically significant difference （ P 〈 O. Ol ）, the stone recurrence rate （0. 00% ） , complications rate （ 3.33% ） of the observation group were statistically lower than the control group （ 16. 67%, 23.33% ）, with statistically significant differences （ P 〈 0. 05 ）. Conclusion The effect of laparoscopic common bile duct exploration for complex hepatolithiasis is good, which not only reduces the operation time and blood loss, but also improves the quality of life of the patients.

关 键 词：肝胆管结石 胆总管探查术 腹腔镜 

分 类 号：R722.12[医药卫生—儿科]