80例胆道结石患者应用腹腔镜联合胆道镜微创治疗的临床分析  

Clinical Analysis of Laparoscopic Combined with Choledochoscopy Minimally Invasive Treatment in 80 Patients with Biliary Calculi

作　　者：孟洁[1] MENG Jie(Department of General Surgery, Handan Second Hospital, Handan, Hebei Province, 056001 China)

机构地区：[1]邯郸市第二医院普外科,河北邯郸056001

出　　处：《中外医疗》2019年第7期26-28,共3页China & Foreign Medical Treatment

摘　　要：目的探讨腹腔镜联合胆道镜微创治疗在胆道结石患者治疗中的临床效果。方法方便选取该院2017年6月—2018年6月收治的80例胆道结石患者进行分析,随机分成观察组和对照组,两组各40例患者,观察组患者采用腹腔镜联合胆道镜进行微创治疗,对照组患者采用传统开腹手术治疗,对照两组患者的手术时间、引流管置入时间、肠道恢复时间、住院时间、并发症、血清炎症反应、血清内一元胺神经递质评分。结果观察组患者手术时间、引流管置入时间、肠道恢复时间、住院时间均短于对照组(t=15.052 6, 20.587 2, 25.497 1, 13.755 9,P=0.002, 0.008, 0.003, 0.005),观察组并发症发生率为2.5%,对照组并发症发生率为32.5%,观察组患者的并发症发生率低于对照组(χ~2=2.125, P=0.026),观察组IL-1β(μmol/L),IL-6 (ng/L),IL-8 (ng/L),PCT (μg/L),TNF-α(μg/L),hs-CRP (mg/L)评分分别是(5.28±0.61)μmol/L,(7.92±0.85)ng/L,(8.63±0.91)ng/L,(1.73±0.19)μg/L,(0.91±0.09)μg/L,(4.28±0.53)mg/L,对照组分别为(9.11±0.96)μmol/L,(11.17±1.95)ng/L,(12.75±1.83)ng/L,(4.12±0.53)μg/L,(2.76±0.34)μg/L,(8.17±0.92)mg/L,观察组血清中一元胺递质含量评分低于对照组(t=7.124,P=0.022),观察组血清炎症反应评分低于对照组,两组差异有统计学意义(t=7.923,6.784,,9.182,6.732,5.384,P=0.024,0.015,0.033,0.011,0.016)。结论在胆道结石治疗环节中,结合腹腔镜联合胆道镜微创治疗效果好于常规开腹手术,在临床上有非常好的应用前景,值得在临床上推广和使用。Objective To investigate the clinical effect of laparoscopic combined with minimally invasive choledochoscopy in the treatment of patients with biliary calculi. Methods 80 patients with biliary calculi admitted to our hospital from June2017 to June 2018 were convenient divided into observation group and control group. 40 patients in the observation group were treated with laparoscopic and choledochoscopy for minimally invasive surgery. The patients in the control group were treated with conventional open surgery. The operation time, drainage tube placement time, intestinal recovery time, hospitalization time, complications, serum inflammatory response, and serum monoamine neurotransmitter scores were compared between the two groups. Results The operation time, drainage tube placement time, intestinal recovery time and hospitalization time of the observation group were shorter than those of the control group(t=15.052 6, 20.587 2, 25.497 1, 13.755 9. P=0.002, 0.008, 0.003, 0.005). The incidence rate was 2.5%, and the incidence of complications in the control group was32.5%. The incidence of complications in the observation group was lower than that in the control group(χ^2=2.125, P=0.026), and the observation group of IL-1β(μmol/L), IL-6(ng/L), IL-8(ng/L), PCT(μg/L), TNF-α(μg/L), and hs-CRP(mg/L) scores were(5.28±0.61)μmol/L,(7.92±0.85)ng/L,(8.63±0.91)ng/L,(1.73±0.19)μg/L,(0.91±0.09)μg/L,(4.28±0.53)mg/L,and the control group were(9.11±0.96)μmol/L,(11.17±1.95)ng/L,(12.75±1.83)ng/L,(4.12±0.53)μg/L,(2.76±0.34)μg/L,(8.17±0.92)mg/L, serum of the observation group of the monoamine amine transmitter was lower than that of the control group(t=7.124, P=0.022). The serum inflammatory response score of the observation group was lower than that of the control group,and the difference was significant between the two groups(t =7.923, 6.784, 9.182, 6.732, 5.384, P =0.024, 0.015, 0.033,0.011, 0.016). Conclusion In the treatment of biliary calculi, the combination of laparoscopic and choledochoscopy is bette

关 键 词：胆道结石 腹腔镜手术 胆道镜 

分 类 号：R4[医药卫生—临床医学]