腹腔镜辅助小切口下保胆取石即时缝合术治疗胆囊结石疗效观察  

Effect of laparoscopic-assisted mini-incision gallbladder-preserving lithotripsy with immediate suture on cholecystolithiasis

作　　者：徐杰 王杏土 孙道中 王鹏 Xu Jie;Wang Xingtu;Sun Daozhong;Wang Peng(Department of General Surgery,Zhejiang Lyucheng Cardiovascular Hospital,Hangzhou,Zhejiang 310000,China)

机构地区：[1]浙江绿城心血管病医院普外科,杭州310000

出　　处：《中国基层医药》2020年第15期1841-1844,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察腹腔镜辅助小切口下保胆取石即时缝合术治疗胆囊结石的疗效。方法选取浙江绿城心血管病医院普外科2017年11月至2018年11月手术治疗的胆囊结石患者90例,根据不同术式分为对照组45例、观察组45例,对照组采用腹腔镜胆囊切除术治疗,观察组采用腹腔镜辅助小切口下保胆取石即时缝合术治疗,比较两组手术相关指标、术后康复指标、并发症及临床疗效。结果观察组手术时间、出血量、切口长度分别为(46.5±4.2)min、(33.9±3.4)mL、(3.2±0.5)cm,短于、小于对照组的(61.8±5.3)min、(51.6±4.5)mL、(5.6±0.8)cm,差异均有统计学意义(t=16.412、10.307、4.763,均P<0.05);观察组禁食、肛门排气、下床活动、住院时间分别为(1.4±0.4)d、(1.3±0.2)d、(1.5±0.5)d、(5.4±0.9)d,均短于对照组的(2.0±0.6)d、(2.2±0.3)d、(2.4±0.7)d、(8.3±1.6)d(t=7.050、10.085、7.848、12.357,均P<0.05);观察组并发症发生率为2.2%(1/45),低于对照组的13.3%(6/45)(χ^2=5.001,P<0.05);观察组总有效率为95.6%(43/45),高于对照组的80.0%(36/45)(χ^2=4.473,P<0.05)。结论腹腔镜辅助小切口下保胆取石即时缝合术治疗胆囊结石的效果理想,可明显改善临床相关指标,降低并发症发生率。Objective To observe the effect of laparoscopic assisted small incision in the treatment of gallstone.Methods From November 2017 to November 2018,90 patients with gallstone were selected from the general surgery department of Zhejiang Lyucheng Cardiovascular Hospital.According to different operation methods,they were divided into control group(45 cases)and observation group(45 cases).The control group was treated with laparoscopic cholecystectomy,and the observation group was treated with laparoscopic assisted small incision and immediate suture of cholelithiasis.The operation related indicators,postoperative rehabilitation indicators,complications and clinical effect of the two groups were compared.Results The operation time,bleeding volume and incision length of the observation group were(46.5±4.2)min,(33.9±3.4)mL,(3.2±0.5)cm,respectively,which were shorter than those of the control group[(61.8±5.3)min,(51.6±4.5)mL and(5.6±0.8)cm](t=16.412,10.307,4.763,all P<0.05).The time of fasting,anal exhaust,ambulation and hospitalization in the observation group were(1.4±0.4)d,(1.3±0.2)d,(1.5±0.5)d,(5.4±0.9)d,respectively,which were shorter than those in the control group[(2.0±0.6)d,(2.2±0.3)d,(2.4±0.7)d,(8.3±1.6)d](t=7.050,10.085,7.848,12.357,all P<0.05).The incidence of complications in the observation group was 2.2%(1/45),which was lower than 13.3%(6/45)in the control group(χ^2=5.001,P<0.05).The total effective rate in the observation group was 95.6%(43/45),which was higher than 80.0%(36/45)in the control group(χ^2=4.473,P<0.05).Conclusion The effect of laparoscopic assisted small incision choledocholithotomy and immediate suture is ideal,which can significantly improve the clinical indicators and reduce the incidence of complications.

关 键 词：胆囊结石病 腹腔镜检查 胆囊切除术 腹腔镜 小切口 保胆取石 时间 出血 手术后并发症 对比研究 

分 类 号：R657.42[医药卫生—外科学]