内镜微创保胆取石术治疗胆囊结石的临床效果  

Clinical Effect of Endoscopic Minimally Invasive Cholecystolithotomy in the Treatment of Cholecystolithiasis

作　　者：张林丰 张玉沛 ZHANG Linfeng;ZHANG Yupei(Jingmen Hospital of Traditional Chinese Medicine,Jingmen 448000,China;不详)

机构地区：[1]荆门市中医医院,湖北荆门448000

出　　处：《中外医学研究》2021年第14期21-23,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：湖北省自然科学基金面上类项目(2019CFC859)。

摘　　要：目的:探讨内镜微创保胆取石术治疗胆囊结石的临床疗效。方法:纳入2017年1月-2019年12月本院80例胆囊结石患者。按照随机数字表法分为对照组和观察组,各40例。对照组实施开腹胆囊切除术,观察组实施内镜微创保胆取石术。比较两组手术情况、术后并发症发生率、术后恢复时间、住院时间、术后血清炎症因子水平、术后疼痛评分。结果:两组手术时间比较差异无统计学意义(t=0.271,P=0.787),观察组术中出血量为(30.27±9.15)ml,少于对照组(t=17.826,P=0.000)。观察组术后并发症发生率为2.50%,低于对照组的15.00%(χ^(2)=3.914,P=0.048)。观察组术后首次排气时间、恢复进食时间、住院时间均优于对照组(t=4.739、5.299、5.009,P=0.000、0.000、0.000)。术后第1、2、3天,观察组血清C反应蛋白水平低于对照组(t=4.797、4.662、4.667,P=0.000、0.000、0.000),白细胞介素-6水平观察组低于对照组(t=5.132、5.092、4.806,P=0.000、0.000、0.000)。术后12、24、36、48 h,观察组疼痛评分均较对照组更低(t=4.773、5.240、5.361、5.228,P=0.000、0.000、0.000、0.000)。结论:内镜微创保胆取石术用于胆囊结石可有效减轻手术创伤,减轻术后炎性因子渗出和疼痛感,有利于减少术后并发症,加快术后恢复。Objective:To investigate the clinical effect of endoscopic minimally invasive cholecystolithotomy in the treatment of cholecystolithiasis.Method:From January 2017 to December 2019,80 patients with cholecystolithiasis in our hospital were included and divided into the control group and the observation group according to random number table method,with 40 cases in each group.The control group underwent open cholecystectomy,while the observation group underwent endoscopic minimally invasive cholecystolithotomy.The operation situation,incidence of postoperative complications,postoperative recovery time,hospital stay,postoperative serum inflammatory factors levels and postoperative pain score were compared between the two groups.Result:There was no significant difference in the operative time between the two groups(t=0.271,P=0.787),the intraoperative blood loss in the observation group was(30.27±9.15)ml,which was less than that in the control group(t=17.826,P=0.000).The incidence of postoperative complications was 2.50%in the observation group,which was lower than 15.00%in the control group(χ^(2)=3.914,P=0.048).The postoperative first exhaust time,time to resume feeding and hospital stay in the observation group were better than those in the control group(t=4.739,5.299,5.009,P=0.000,0.000,0.000).At 1,2 and 3 d after surgery,the serum C-reactive protein level in the observation group was lower than that in the control group(t=4.797,4.662,4.667,P=0.000,0.000,0.000),and the interleukin-6 level in the observation group was lower than that in the control group(t=5.132,5.092,4.806,P=0.000,0.000,0.000).At 12,24,36 and 48 h after surgery,the pain scores in the observation group were lower than those in the control group(t=4.773,5.240,5.361,5.228,P=0.000,0.000,0.000,0.000).Conclusion:Endoscopic minimally invasive cholecystolithotomy for cholecystolithiasis can effectively reduce surgical trauma,reduce postoperative inflammatory factor exudation and pain,and is beneficial to reduce postoperative complications and speed up pos

关 键 词：胆囊结石 内镜 保胆取石术 开腹手术 并发症 微创手术 

分 类 号：R657.4[医药卫生—外科学]