腹腔镜微创术式与开腹术式治疗胆总管结石的疗效比较  

Comparison of laparoscopic minimally invasive surgery and laparotomy in the treatment of choledocholithiasis

作　　者：白石 Bai Shi(Department of General Surgery,Yichun Hospital of Traditional Chinese Medicine,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市中医院普外科,江西宜春336000

出　　处：《当代医学》2020年第24期18-20,共3页Contemporary Medicine

摘　　要：目的探析腹腔镜微创手术方式与传统开腹手术方式治疗胆总管结石的临床应用效果。方法选取2017年5月至2019年5月于本院治疗的胆总管结石患者74例作为研究对象,按随机数字法分为对照组和观察组,各37例。观察组采取腹腔镜下胆总管切口取石术,对照组采取开腹胆总管取石术并行T管引流。观察对比两组患者术中出血量、手术时间、术后8 h疼痛评分、胃肠功能恢复时间、住院时间、住院费用以及术后并发症发生情况。结果观察组患者术中出血量和术后8 h疼痛评分明显低于对照组,观察组胃肠功能恢复时间和住院时间明显短于对照组(P<0.05);观察组手术时间明显长于对照组,住院费用明显高于对照组(P<0.05);观察组患者术后并发症发生率明显低于对照组(P<0.05)。结论与开腹手术比较,腹腔镜微创手术时间更长,住院费用略高,但术中出血量较少、胃肠功能恢复时间较短,术后并发症较少,可结合患者自身具体情况选择相应术式。Objective To explore the clinical effect of laparoscopic minimally invasive surgery and traditional laparotomy in the treatment of common bile duct stones.Methods 74 patients with common bile duct stones who were treated in our hospital from May 2017 to May 2019 were selected as the study subjects.They were randomly divided into control group and observation group,with 42 cases in each group.The Observation group underwent laparoscopic common bile duct incision for stone removal,while control group underwent open cholecystectomy for T-tube drainage.The blood volume,operation time,pain score,recovery time of gastrointestinal function,hospitalization time,hospitalization expenses and complications were observed and compared between the two groups.Results The blood volume and pain score of the patients in the observation group were significantly lower than those in the control group,and the recovery time of gastrointestinal function and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).The operation time of the observation group was significantly longer than that of the control group,and the hospitalization cost was significantly higher than that of the control group(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Compared with open surgery,laparoscopic minimally invasive surgery has longer duration and higher hospitalization costs,but it has lower intraoperative bleeding,earlier recovery of gastrointestinal function,fewer complications and less complications.They can choose the appropriate surgical method according to their own specific conditions.

关 键 词：腹腔镜微创术式 胆总管结石 开腹术式 效果 并发症 住院费用 

分 类 号：R657.42[医药卫生—外科学]