“水冲取石法”在腹腔镜保胆手术中的应用及临床分析  

Application and clinical analysis of “water flushing stone method” in laparoscopic gallbladder-preserving surgery

作　　者：王红伟 刘江伟[1] 冯德元 林海 郑文建 李廷军[1] 高伟[1] 康燕 WANG Hong-wei;LIU Jiang-wei;FENG De-yuan(General Hospital of Xinjiang Military Command,Urumqi 830000,China)

机构地区：[1]新疆军区总医院 [2]解放军69240部队

出　　处：《腹腔镜外科杂志》2018年第8期598-601,共4页Journal of Laparoscopic Surgery

基　　金：新疆维吾尔自治区科技计划项目(编号:201042145)

摘　　要：目的:探讨腹腔镜保胆手术中应用"水冲取石法"治疗多发胆囊结石的应用及临床疗效。方法:选取2016年1月至2018年1月治疗的胆囊多发小结石患者。首先将符合纳入标准的患者随机分为3组,每组20例,于保胆取石过程中分别采用不同的冲洗压力(60 mmHg、70 mmHg、80 mmHg),以确定水冲取石法最适宜的冲洗压力值。将符合纳入标准的60患者随机分为水冲取石组与网篮取石组,每组30例,比较两种取石方式单位时间(min)取石数量、排气时间、住院时间、拆线时间。结果:70 mmHg组与80 mmHg组单位时间(min)取石数量大于60 mmHg组,差异有统计学意义(P<0.05);但70 mmHg组与80 mmHg组之间差异无统计学意义(P>0.05)。水冲取石法单位时间(min)的取石数量优于网篮取石组(P<0.05),两组首次肛门通气时间、术后住院时间及拆线时间差异无统计学意义(P>0.05)。结论:腹腔镜保胆手术中应用"水冲取石法"治疗多发胆囊小结石具有术中取石时间短的优势,其最适宜的冲洗压力为70 mmHg。Objective：To explore the application and clinical efficacy of ＂water flushing stone method＂ in the treatment of multiple small gallstones in laparoscopic gallbladder-preselwing surgeu.Methods ：The study selected patients with multiple small gallstones fi＇om Jan.2016 to Jan.2018.The patients who met the inclusion criteria were randomly divided into 3 groups （n= 20） , and different irrigation pressure values （60 mmHg,70 mmHg,80 mmHg） were used to wash and remove stones during the process of removing gallstones,in order to determine the optimum flushing pressure value of ＂water flushing stone method＂ .60 patients who met the inclusion criteria were randomly divided into two groups ： the water flushing stone group （ n = 30） and the basket stone removal group （ n = 30）. The removed stone number in unit time （min） ,exhaust time,postoperative hospitalization time and suture removal time were compared between the two groups.Results：The removed stone number in unit time （min） was more in the 70 mmHg group and the 80 mmHg group than that in the 60 mmHg group （P〈0.05） ,and there was no significant difference belween the 70 mmHg group and the 80 ram- Hg group （P〉0.05）.The 70 mmHg was detennined as the optimum flushing pressure value.The water flushing stone group was better than basket stone removal group in the number of stones removed per unit time （P〈0.05）.There were no significant differences in the first anal ventilation time, postoperative hospitalization time, and suture removal time between the two groups. Conclusions：＂ Water flushing stone method＂ has the advantage of short stone removal time in laparoscopic gallbladder-preserving surgery for the treatment of multiple small gallstones.The optimum flushing pressure value is 70 mmHg.

关 键 词：胆囊结石病 保胆手术 腹腔镜检查 水冲取石法 

分 类 号：R657.4[医药卫生—外科学]