腹腔镜手术治疗老年胆结石的临床体会  

Clinical value of laparoscopic operation in the treatment of elderly patients with gallstones

作　　者：廖全辉[1] 沈绍信[1] 

机构地区：[1]福建省龙岩市第一医院肝胆外科,福建龙岩364000

出　　处：《中国现代医生》2016年第27期52-54,共3页China Modern Doctor

摘　　要：目的研究腹腔镜用于老年胆结石治疗的临床价值。方法 研究资料来源于我院2014年9月-2016年1月收治的老年胆结石患者100例,根据随机数字表法分为腹腔镜组和小切口组两组。小切口组采用开腹小切口手术进行治疗;腹腔镜组采取腹腔镜手术进行治疗。对两组患者手术操作耗时、手术切口长度、术中出血总量、术后排气时间、术后疼痛评分、术后住院天数和止痛药使用率、并发症发生率进行比较。并比较两组患者术后生理、情感、社会功能和生存质量总分。结果 腹腔镜组止痛药使用率、并发症发生率低于小切口组（P〈0.05）。腹腔镜组患者手术操作耗时、手术切口长度、术中出血总量、术后排气时间、术后疼痛评分、术后住院天数均少于小切口组（P〈0.05）。腹腔镜组患者术后生理、情感、社会功能和生存质量总分优于小切口组（P〈0.05）。结论 腹腔镜用于老年胆结石治疗的具有较高的临床价值,创伤小,手术安全有效,因切口小,创伤小,术中可减少失血量,减少切口感染等并发症的发生,有利于加快手术后患者的机体功能恢复,减轻患者痛苦,缩短术后住院天数,减轻患者经济负担,还有助于提高患者术后生存质量,值得推广。Objective To study the clinical value of laparoseopy in the treatment of elderly patients with gallstones. Methods Data from September 2014 to January 2016 in our hospital were treated with 100 cases of elderly patients with gallstones, according to the random number table method, divided into two groups, laparoscopic group and small incision group. Small incision group was treated by open small incision surgery; laparoscopic group was treated by laparoscopic surgery. Operation time, incision length, total amount of bleeding, postoperative exhaust time, postoperative pain score, postoperative hospital stay and pain medication use rate and incidence of complications were compared between the two groups. And compared the two groups of patients with postoperative physical, emotional, social func- tion and quality of life score. Results The rate of use of pain medication in laparoscopie group, the incidence of com- plications was lower than that of small incision group（P〈0.05）. The operation time, incision length, total amount of bleeding, postoperative exhaust time, postoperative pain score, postoperative hospital stay in laparoscopic group were less than that in small incision group（P〈0.05）. The total score of physiological, emotional, social function and quality of life of the patients in the laparoscopic group were better than that of the small incision group（P〈0.05）. Conclusion For laparoseopic high clinical value in the treatment of cholelithiasis, trauma, surgery is safe and effective, because of the small incision, small trauma and operation can decrease the volume of blood loss, reduce the incidence of wound infection and other complications, can accelerate the recovery of the body function of patients after operation, reduce the suffering of patients, shorten the postoperative hospitalization days, reduce the economic burden of the patients, but also help to improve patients quality of life, worthy of promotion.

关 键 词：腹腔镜 老年胆结石 临床价值 小切口 排气时间 

分 类 号：R657.4[医药卫生—外科学]