双镜联合规范化治疗胆总管合并胆囊结石临床效果观察  

Observation on the clinical effect of double mirror combined with standardization in the treatment of common bile duct complicated with cholecystolithiasis

作　　者：李兴禹 何立春 卢永宝 王志新 王浩楠 Li Xingyu;He Lichun;Lu Yongbao;Wang Zhixin;Wang Haonan(General Surgery,Jinta County People's Hospital,Jiuquan 735000,China)

机构地区：[1]甘肃省酒泉市金塔县人民医院普通外科,735000

出　　处：《现代养生》2022年第8期575-577,共3页Health Protection and Promotion

摘　　要：目的 探析采用腹腔镜联合术中胆道镜治疗胆总管合并胆囊结石患者的疗效。方法 选择2018年9月-2020年9月医院采取手术方法医治的60例胆总管合并胆囊结石患者作为研究对象,根据组间基本资料均衡可比的原则分为观察组和对照组,每组30例。对照组实行常规胆囊切除结合胆道切开取石医治,观察组实行腹腔镜结合术中胆道镜医治,将两组患者手术指标以及并发症发生率进行对比。结果 观察组手术时长、术中出血量、术后肛门排气时长、术后下床活动时长和住院时间等手术指标均优于对照组,差异有统计学意义(P<0.05)。手术前两组免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)差异无统计学意义(P>0.05);手术后,两组IgA、IgM、IgG均有所降低,但观察组IgA、IgM、IgG水平高于对照组,差异有统计学意义(P<0.05)。手术后,观察组患者的并发症发生率低于对照组,但差异无统计学意义(P<0.05)。结论 采用腹腔镜联合术中胆道镜治疗胆总管合并胆囊结石,可以防止手术中出血量过多,可明显缩短住院时间,值得在临床中推广应用。Objective To explore the efficacy of laparoscopy combined with intraoperative choledochoscopy in the treatment of patients with common bile duct complicated with cholecystolithiasis. Methods A total of 60 patients with common bile duct complicated with cholecystolithiasis who were treated by surgical methods in the hospital from September 2018 to September 2020 were selected as the research subjects. According to the principle of balance and comparability of basic data between groups, they were divided into an observation group and a control group, with 30 cases in each group. The control group was treated with conventional cholecystectomy combined with choledochotomy and stone extraction, and the observation group was treated with laparoscopy combined with intraoperative choledochoscopy. The surgical indicators and the incidence of complications were compared between the two groups.Results The operation time, amount of bleeding, postoperative anal exhaust time, postoperative out of bed activity time and hospital stay in the observation group were better than those in the control group(P<0.05). There was no significant difference in IgA, IgM and IgG between the two groups before operation(P> 0.05);After operation, the levels of IgA,IgM and IgG in the observation group were significantly higher than those in the control group P<0.05). After operation,the incidence of complications in the observation group was lower than that in the control group, but the difference was not statistically significant(P >0.05). Conclusion Laparoscopy combined with intraoperative choledochoscopy in the treatment of common bile duct complicated with gallstone can prevent excessive bleeding during operation and significantly shorten the hospital stay, which is worthy of popularization and application in clinic.

关 键 词：腹腔镜 术中胆道镜 胆囊结石 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]