开腹和腹腔镜肝切除术治疗肝左叶胆管结石的早期及远期临床效果比较  

Comparison of Early and Long-term Clinical Effects of Open and Laparoscopic Hepatectomy in the Treatment of Liver Left Lobe Bile Duct Stones

作　　者：韩菁华 Han Jinghua(Department of Surgery,Yucheng County No.2 People's Hospital,Henan Province,Shangqiu 476300)

机构地区：[1]河南省虞城县第二人民医院外二科,商丘476300

出　　处：《数理医药学杂志》2022年第5期663-665,共3页Journal of Mathematical Medicine

摘　　要：目的:比较开腹和腹腔镜肝切除术治疗肝左叶胆管结石的早期及远期临床效果。方法:收集2020年8月-2021年8月期间某院入住且符合本研究纳入标准的肝左叶胆管结石患者88例,以随机数表法将患者进行分组,分为对照组和观察组各44例,对照组采用传统开腹手术,观察组采用腹腔镜肝切除术,对比两组手术疗效、围术期恢复指标、术后生化指标、并发症发生率、后期复发率。结果:观察组整体治疗有效率为100.00%显著高于对照组的90.91%(P<0.05)。观察组术中出血量、手术时间、饮食恢复时间、术后镇痛时间以及自主活动时间均低于对照组(P<0.05)。术前两组生化指标对比无差异(P>0.05);术后观察组血红蛋白、白细胞计数均低于对照组(P<0.05)。观察组复发率与对照组对比无较大差异(P>0.05)。观察组并发症率为2.86%显著低于对照组的18.18%(P<0.05)。结论:左叶胆管结石使用腹腔镜肝切除术较传统开腹手术近期与远期效果均较好,可提升手术质量,在围术期获得较好的治疗效果,并控制并发症发生率,同时后期复发率较低,可进行临床推广普及。Objective:To compare the early and long-term clinical effects of open and laparoscopic hepatectomy in the treatment of liver left lobe bile duct stones.Methods:88 patients with liver left lobe bile duct stones admitted to a hospital from August 2020 to August 2021 and meeting the inclusion criteria of this study were collected and divided into control group(44 cases)and observation group(44 cases)by random number table method.The control group received traditional open surgery,and the observation group was given laparoscopic hepatectomy,then the operative efficacy,perioperative recovery indexes,postoperative biochemical indexes,incidence of complications and later recurrence rate were compared between the two groups.Results:The overall effective rate of the observation group was 100.00%,significantly higher than 90.91%of the control group(P<0.05).The amount of intraoperative bleeding,operation time,diet recovery time,postoperative analgesia time and independent activity time in the observation group were lower than those in the control group(P<0.05).There was no difference in biochemical indexes between the two groups before operation(P>0.05).The hemoglobin and leukocyte counts in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the recurrence rate between the observation group and the control group(P>0.05).The incidence of complications of the observation group was 2.86%,significantly lower than that of the control group(18.18%)(P<0.05).Conclusion:Laparoscopic hepatectomy for liver left lobe bile duct stones has better short-term and long-term effects than traditional open surgery,which can improve the quality of surgery,obtain better therapeutic effect in the perioperative period,and control the incidence of complications,with low later recurrence rate at the same time,and can be popularized clinically.

关 键 词：开腹手术 腹腔镜肝切除术 肝左叶胆管结石 早期疗效 远期疗效 

分 类 号：R575.7[医药卫生—消化系统]