单向倒刺线连续一期缝合胆总管方式在双镜联合治疗胆总管结石术中的应用效果及安全性  

Application effect and safety of one-way barbed suture for continuous primary suture of common bile duct in the combined endoscopic treatment of choledocholithiasis

作　　者：廖军波 邱伟 刘阳[2] LIAO Junbo;QIU Wei;LIU Yang(the First Hospital of Hanbin District,Ankang 725000;the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]安康市汉滨区第一医院,陕西安康725000 [2]西安交通大学第二附属医院,陕西西安710004

出　　处：《临床医学研究与实践》2022年第9期44-47,共4页Clinical Research and Practice

基　　金：陕西省自然科学基础研究计划项目(No.2020JM-404)。

摘　　要：目的探讨单向倒刺线连续一期缝合胆总管方式在双镜联合治疗胆总管结石术中的应用效果及安全性。方法回顾性分析2018年2月至2021年2月于本院行双镜联合治疗胆总管结石术的30例患者的临床资料,依据不同一期缝合方式将患者分为对照组和观察组,各15例。对照组采用薇荞线行间断缝合,观察组采用单向倒刺线行连续缝合。比较两组的应用效果。结果观察组的手术时间、胆总管缝合时间短于对照组,术中出血量少于对照组,术中疼痛评分低于对照组(P<0.05)。术后12 h,两组的ACTH、Cor、NE水平均高于术前,但观察组低于对照组,差异具有统计学意义(P<0.05)。两组的并发症总发生率、术后进食时间、术后引流管拔除时间、住院时间、术后3 d的IL-6、hs-CRP水平及术后胆管结石残留、复发发生率比较,差异均无统计学意义(P>0.05)。结论单向倒刺线连续一期缝合胆总管方式应用于双镜联合治疗胆总管结石术中,可缩短手术和缝合用时,减少术中出血量,减轻手术应激反应,且不会增加并发症发生风险。Objective To investigate the application effect and safety of one-way barbed suture for continuous primary suture of common bile duct in the combined endoscopic treatment of choledocholithiasis.Methods The clinical data of 30 patients undergoing combined endoscopic treatment of choledocholithiasis in our hospital from February 2018 to February 2021 were analyzed retrospectively,and the patients were divided into control group and observation group according to different primary suture methods,with 15 cases in each group.The control group used buckwheat thread for intermittent suture,and the observation group used one-way barbed suture for continuous suture.The application effects of the two groups were compared.Results The operation time and common bile duct suture time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the intraoperative pain score was lower than that of the control group(P<0.05).At 12 h after operation,the levels of ACTH,Cor and NE in the both groups were higher than those before operation,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).There were no significant differences in total incidence of complications,postoperative feeding time,postoperative drainage tube removal time,hospital stay,IL-6 and hs-CRP levels at 3 d after operation,incidences of postoperative residual and recurrence of bile duct stones between the two groups(P>0.05).Conclusion One-way barbed suture for continuous primary suture of common bile duct in the combined endoscopic treatment of choledocholithiasis can shorten the operation and suture time,reduce the intraoperative blood loss,relieve the surgical stress response,and do not increase the occurrence risk of complications.

关 键 词：单向倒刺线 一期缝合 双镜联合治疗 胆总管结石 应激反应 结石残留 

分 类 号：R657.4[医药卫生—外科学]