腹腔镜与胆道镜双镜联合术应用于胆囊结石合并胆总管结石的临床治疗研究  

Laparoscopy and Choledochoscopy Combined with Double Mirrors for the Clinical Treatment of Gallstones Combined with Choledocholithiasis

作　　者：关聪聪 GUAN Cong-cong(General Surgery,Beijing Jiangong Hospital,Beijing,100054 China)

机构地区：[1]北京市健宫医院普外科,北京100054

出　　处：《中外医疗》2021年第1期48-50,59,共4页China & Foreign Medical Treatment

摘　　要：目的分析腹腔镜与胆道镜双镜联合术应用于胆囊结石合并胆总管结石的临床治疗效果。方法简单随机选择2015年1月—2019年12月期间该院收治的203例胆囊结石合并胆总管结石患者,根据不同手术方式将患者分成了观察组和对照组,其中观察组102例接受腹腔镜与胆道镜双镜联合术治疗,对照组101例接受常规开腹手术治疗,对比两组患者的治疗效果、手术康复情况、术后疼痛度、生活质量以及不良反应发生率。结果观察组的治疗效果为98.04%,对照组的治疗效果为90.09%,观察组高于对照组,差异有统计学意义(χ^(2)=5.753,P=0.016)。观察组的手术时间、术中出血量、腹腔引流时间、恢复普食时间、术后住院时间等手术康复情况分别为(88.6±17.3)min、(10.1±5.1)mL、(3.4±1.1)d、(16.1±1.2)h、(5.5±1.3)d,均优于对照组(94.2±14.3)min、(11.6±4.4)mL、(4.7±1.5)d、(23.6±1.5)h、(7.4±1.3)d,差异有统计学意义(t=2.512、2.243、7.046、39.356、10.412,P<0.05)。观察组的术后1、3、5 d的疼痛程度分别为(4.15±0.34)分、(3.02±0.14)分、(1.04±0.12)分,均要低于对照组(6.38±0.52)分、(4.64±0.35)分、(3.17±0.82)分,差异有统计学意义(t=36.197、43.374、25.956,P<0.05)。观察组的生理功能、心理状态、独立性、社会关系等生活质量分别为(32.88±8.65)分、(21.32±6.57)分、(30.95±6.18)分、(23.14±6.38)分,均要高于对照组(21.56±6.74)分、(12.98±8.64)分、(15.54±6.24)分、(13.54±2.35)分,差异有统计学意义(t=10.394、7.746、17.678、14.198,P<0.05)。观察组的胆漏、胆道感染、胰腺炎等不良反应发生率为2.94%,低于对照组10.89%,差异有统计学意义(χ^(2)=4.995,P=0.025)。结论腹腔镜与胆道镜双镜联合术应用于胆囊结石合并胆总管结石的临床治疗效果显著,能够有效促进患者术后身体的恢复。Objective To analyze the clinical effect of combined laparoscopic and choledochoscope dual-scopy in the treatment of gallbladder stones with choledocholithiasis.Methods simple random selected 203 patients with gallbladder stones and choledocholithiasis in the hospital from January 2015 to December 2019.The patients were divided into observation group and control group according to different surgical methods,102 cases in the observation group received combined laparoscopic and choledochoscopy combined treatment.101 cases in the control group received conventional open surgery.The treatment effect,surgical recovery,postoperative pain and quality of life,and the incidence of adverse reactions of the two groups were compared.Results The treatment effect of the observation group was 98.04%,the treatment effect of the control group was 90.09%,the observation group was higher than the control group,the difference was statistically significant(χ^(2)=5.753,P=0.016).The operation time,intraoperative blood loss,abdominal drainage time,time to restore general food,and postoperative hospital stay in the observation group were(88.6±17.3)min,(10.1±5.1)mL,(3.4±1.1)d,(16.1±1.2)h,and(5.5±1.3)d,were better than the control group(94.2±14.3)min,(11.6±4.4)mL,(4.7±1.5)d,(23.6±1.5)h,(7.4±1.3)d,the difference was statistically significant(t=2.512,2.243,7.046,39.356,10.412,P<0.05).The pain degrees of the observation group at 1,3,and 5 d after surgery were(4.15±0.34)points,(3.02±0.14)points,(1.04±0.12)points,which were lower than those of the control group(6.38±0.52)points,(4.64±0.35)points,(3.17±0.82)points,the difference was statistically significant(t=36.197,43.374,25.956,P<0.05).The quality of life of the observation group,such as physiological function,mental state,independence,and social relations,were(32.88±8.65)points,(21.32±6.57)points,(30.95±6.18)points,(23.14±6.38)points,which were higher than those of the control group(21.56±6.74)points,(12.98±8.64)points,(15.54±6.24)points,(13.54±2.35)points,the differ

关 键 词：腹腔镜 胆道镜 双镜联合术 胆囊结石 胆总管结石 

分 类 号：R4[医药卫生—临床医学]