腹腔镜胆囊次全切除术治疗复杂性胆囊疾病的效果探讨  

Therapeutic analysis and clinical experience of laparoscopic cholecystectomy for complicated gallbladder diseases

作　　者：李钢 高洪强 宋斌 翁黎明 巴雅尔 马靓 Li Gang;Gao Hongqiang;Song Bin;Weng Liming;Bayaei;Ma Liang(Department of General Surgeiy Fengcheng Hospital of Fengxian District,Shanghai 201411, China)

机构地区：[1]上海市奉贤区奉城医院普外科,上海201411

出　　处：《医药前沿》2019年第17期16-17,共2页Journal of Frontiers of Medicine

摘　　要：目的:探讨腹腔镜胆囊切除术对于复杂性胆囊疾病的临床疗效及术后康复情况.方法:选取2014年1月—2018年6月我院普外科收治入院的84例复杂性胆囊疾病患者,随机分为对照组(42例)与观察组(42例).对照组采用腹腔镜逆行切除术,观察组采用腹腔镜次全切除术,比较两组在手术情况,并发症发生率以及术后康复方面的差异.结果:在手术时间、术中出血量、术中补液量等手术指标方面,观察组显著优于对照组(P<0.05).两组在腹腔引流量(ml/d)和术后引流时间(d)方面没有显著差异(P>0.05),观察组在胃肠功能恢复时间、进食时间、下床活动时间以及住院时间短于对照组,差异显著(P<0.05).此外,并发症的发生率也低于对照组,差异显著(P<0.05).结论:相比于腹腔镜逆行切除术,采用腹腔镜次全切除术治疗复杂性胆囊疾病可显著改善手术指标以及患者术后康复,并且可降低并发症风险,安全性高.Objective To investigate the clinical efficacy and postoperative rehabilitation of laparoscopic cholecystectomy for complicated gallbladder disease. Methods The clinical data of 84 patients with complicated gallbladder disease who were admitted to our hospital from January 2014 to June,2018 were retrospectively analyzed. They were divided into control group (42 cases) and observation group (42 cases) according to different surgical methods. Laparoscopic retrograde resection was performed in the control group, and subtotal laparoscopic resection was performed in the observation group. The differences in the operation related index, complication rate, and postoperative rehabilitation were compared between the two groups. Results In the operation time, intraoperative blood loss and intraoperative fluid transfusion volume, the observation group was significantly better than the control group (P<0.05). There was no difference between the two groups in the abdominal drainage volume (ml/ d) and postoperative drainage time (d)(P>0.05). The observation group was superior to the control group in the recovery time of gastrointestinal function, time to take food, time to get out of bed and hospitalization time.(P<0.05). In addition, the complication rate was also lower than that of the control group (P<0.05). Conclusion Compared with laparoscopic retrograde resection, laparoscopic subtotal resection for complex gallbladder disease can significantly improve operation related index and postoperative rehabilitation, and can reduce the risk of complications.

关 键 词：腹腔镜胆囊切除术 复杂性胆囊疾病 疗效分析 临床体会 

分 类 号：R615[医药卫生—外科学]