肝内胆管结石腹腔镜肝切除术可行性和效果分析  

Feasibility and Effect Analysis of Laparoscopic Liver Resection for Intrahepatic Bile Duct Stones

作　　者：秦勇[1] 赵雄齐[1] 曹俊,[1] QIN Yong;ZHAO Xiong-qi;CAO Jun(Hepatobiliary and Pancreatic Surgery,Kunming First People's Hospital,Kunming,Yunnan Province,650000 China)

机构地区：[1]云南省昆明市第一人民医院肝胆胰外科

出　　处：《中外医疗》2019年第25期75-77,共3页China & Foreign Medical Treatment

摘　　要：目的探究将腹腔镜肝切除术应用于肝内胆管结石患者治疗中的效果,评价治疗方案的临床应用意义。方法该次研究的实验样本为该院2016年4月-2019年1月时间段内录入的肝内胆管结石患者,对所有患者机体状态进行分析后录入其中62例患者作为该次实验研究对象,对患者随机均分为对照组(n=31)和实验组(n=31)。对照组患者单纯应用开腹手术进行治疗,实验组患者则选择腹腔镜肝切除术方案作为手术方法治疗完成后,对比所有患者术后临床指标并评价治疗效果。结果在该次实验结果中,对照组患者清石率26例(83.87%),实验组患者清石率28例(90.32%),即实验组患者数据优于对照组,组间差异有统计学意义(χ2=1.850 7,P=0.173 7)。患者的手术时间、术中出血量、下床活动时间以及住院时间等各项临床指标对比,实验组更优,组间差异有统计学意义(P<0.05)。并且实验组患者的术后并发症发生率为2例(6.45%),其数据对比对照组8例(25.81%),差异有统计学意义(χ2=13.852 9,P=0.000 1)。结论将腹腔镜肝切除术方案应用于肝内胆管结石患者的治疗中,能够有效保证患者的清石率,同时也有助于改善患者在手术康复后的各项临床指标,降低患者术后并发症发生率,属于安全有效的结石治疗方案,推广意义佳。Objective To investigate the effect of laparoscopic liver resection in the treatment of patients with intrahepatic bile duct stones and evaluate the clinical application of the treatment plan. Methods The experimental samples of this study were patients with intrahepatic bile duct stones admitted to this hospital from April 2016 to January 2019. All patients were analyzed and the 62 patients were enrolled as the experimental study. Subjects were randomly divided into control group (n=31) and experimental group(n=31). The patients in the control group were treated with open surgery alone. The patients in the experimental group were treated with laparoscopic hepatectomy as the surgical method. The clinical indexes of all patients were compared and the therapeutic effects were evaluated. Results In the results of this experiment, the rate of clear stone was 26 cases(83.87%) in the control group and 28 cases(90.32%) in the experimental group. The data of the experimental group were superior to the control group, and the difference between the groups was statistically significant (χ2=1.850 7, P=0.173 7). The experimental group was better in the operation tine, the intraoperative blood loss, the time of getting out of bed, and the hospitalization time. The experimental group was better, and the difference between the groups was statistically significant(P<0.05). The postoperative complication rate was 2 cases(6.45%) in the experimental group, and the data was significantly lower compared with the control group 8 cases(25.81%), and the difference was statistically significant(χ2=13.852 9,P=0.000 1). Conclusion The application of laparoscopic hepatectomy in the treatment of patients with intrahepatic bile duct stones can effectively ensure the patient's rate of clear stone, and also help to improve the clinical indicators of patients after surgery and reduce postoperative complications. The incidence rate is a safe and effective stone treatment program, and the promotion is good.

关 键 词：腹腔镜 微创手术 肝内胆管结石 肝切除术 手术方案 

分 类 号：R657[医药卫生—外科学]