吊线法单孔腹腔镜与传统腹腔镜手术治疗胆囊疾病的疗效和安全性分析  

Analysis of clinical efficacy and safety of suturesuspension single hole laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy in the treatment of gallbladder disease

作　　者：张卫东 金峰 陆炜鑫 

机构地区：[1]南通市通州区第八人民医院普外科,江苏南通226361

出　　处：《中国普外基础与临床杂志》2017年第3期312-316,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的比较吊线法单孔腹腔镜胆囊切除术与传统腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗胆囊疾病的疗效和安全性。方法前瞻性收集笔者所在医院科室于2014年2月至2015年7月期间收治的86例胆囊疾病患者,随机分为对照组43例和试验组43例,对照组患者行传统LC,试验组患者行吊线法单孔腹腔镜胆囊切除术。比较2组患者的临床疗效和安全性。结果 1并发症。2组术后均未发生胆管损伤、胆汁漏、胆管狭窄及脐疝并发症,但术后对照组发生腹痛和腹胀各1例,对照组的并发症发生率与试验组比较差异无意义(P>0.05)。随访期间试验组发生远期并发症1例,对照组发生2例,2组患者的远期并发症发生率比较差异无统计学意义(P>0.05)。2手术一般情况和住院情况。试验组患者的术中出血量和手术时间均低于对照组(P<0.01),但2组患者的住院时间和住院费用比较差异均无统计学意义(P>0.05)。3术后电解质和肝肾功能。试验组患者的血清Na^+和K^+水平均高于对照组,而谷丙转氨酶(alanine aminotransferase,ALT)水平及谷草转氨酶(aspartate aminotransferase,AST)水平均低于对照组,差异均有统计学意义(P<0.01);但2组患者的血尿素氮(BUN)和血清肌酐(SCr)水平比较差异均无统计学意义(P>0.05)。4术后胃肠道功能恢复。试验组患者的肛门首次排气时间和肠鸣音恢复时间均短于对照组,差异均有统计学意义(P<0.01)。结论吊线法单孔腹腔镜胆囊切除术治疗胆囊疾病安全有效、微创,对胃肠道功能和肝功能的干扰小,值得临床应用。Objective To compare the clinical efficacy and safety of suturesuspension single hole laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy （LC） in the treatment of gallbladder disease. Methods A total of 86 cases who got treatment in our hospital from February 2014 to July 2015 were collected prospectively, and then 86 cases were divided into 2 groups： 43 cases of control group underwent LC and 43 cases of experimental group underwent suturesuspension single hole laparoscopic cholecystectomy. Clinical efficacy and safety of the two groups were compared. Results（1） Complication. No one suffered from bile duct injury, bile leakage, bile duct stricture, and umbilical hernia; but there were 2 cases suffered from complications in control group, including 1 case of abdominal pain and 1 case of bloating, and the morbidity was 4.65% （2/43）. The morbidity of experimental group was 0, there was no significant difference between the 2 groups in the morbidity （P〉0.05）. During the follow-up period, 1 case suffered from long-term compilation in experimental group, and 2 cases in normal group, there was no significant difference in the long-term complication between the 2 groups （P〉0.05）. （2） Operation and hospitalization. The blood loss and operation time in the experimental group were lower than those of the control group （P〈0.05）, but there was no significant difference in the hospital stay and hospitalization cost between the 2 groups （P〉0.05）. （3） Postoperative electrolytes, liver and kidney function. The levels of Na^＋ and K^＋ in the experimental group were higher than those of the control group （P〈0.05）, and the levels of alanine aminotransferase and aspartate aminotransferase were lower than those of control group （P〈0.01）, but there was no significant difference in the blood urea nitrogen and serum creatinine between the 2 groups （P〉0.05）. （4） The recovery of gastrointestinal function after surgery. The anal exhaust time and bo

关 键 词：胆囊疾病 吊线法单孔腹腔镜胆囊切除术 腹腔镜胆囊切除术 疗效 安全性 

分 类 号：R657.4[医药卫生—外科学]