吊线法与三器械法应用于经脐单孔腹腔镜胆囊切除术中Calot三角处理的临床效果  

The Application of Suspension Line Method and Three Instrument Method in the Treatment of Calot Triangulation During the Laparoscopic Cholecystectomy Through the Umbilicus

作　　者：常永欣 崔增林[2] CHANG Yong-xin;CUI Zeng-lin(General Surgery,Second People's Hospital of Jiaozuo City,Jiaozuo 454000 China;Department of Urology,The Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000 China)

机构地区：[1]焦作市第二人民医院普外科,河南焦作454000 [2]新乡医学院第三附属医院泌尿外科,河南新乡453000

出　　处：《内蒙古医学杂志》2022年第4期402-404,409,F0004,共5页Inner Mongolia Medical Journal

基　　金：河南省自然科学基金项目(编号:LHGJ20200537)。

摘　　要：目的探讨吊线法与三器械法在经脐单孔腹腔镜胆囊切除术中Calot三角处理中的应用效果。方法将我院收治的93例胆囊良性病变患者随机分为实验组和对照组,分别采用吊线法与三器械法单孔腹腔镜胆囊切除术,比较两组手术时间、术中出血量、Calot三角显露情况、术中中转多孔腹腔镜胆囊切除术、术后肛门排气时间、术后住院时间、术后疼痛程度、使用镇痛药物比率以及术后并发症发生情况。结果(1)实验组和对照组的手术时间为(36.31±10.52)min与(58.84±14.57)min,差异有统计学意义(t=4.762,P=0.000);Calot三角显露良好:实验组占96.00%,对照组占62.79%,差异有统计学意义(χ^(2)=20.293,P=0.000);术后Prince-Henry疼痛评分:实验组为(1.22±0.20),对照组为(2.58±0.18),差异有统计学意义(t=4.526,P=0.020);术后使用镇痛药物:实验组占8.00%,对照组占30.23%,差异有统计学意义(χ^(2)=9.228,P=0.000)。而在术中出血量、术中中转多孔LC、首次下床活动时间、肛门排气时间、平均住院时间和术后并发症(胆漏、切口感染)等方面差异无统计学意义(P>0.05)。结论单孔腹腔镜胆囊切除术中使用吊线法对Calot三角的暴露效果更好,手术时间短,术后疼痛轻,手术操作简单,便于广泛推广。Objective To study and compare the effect of messenger wire method and three instrument method in the processing of Calot triangle in laparoscopic cholecystectomy.Methods 93 cases of patients with gallbladder benign lesions were randomly divided into experimental group and control group,respectively by the methods of messenger wire and three instruments single-arch laparoscopic cholecystectomy,compared two groups of operation time,intraoperative blood loss,Calot triangle show case,intraoperative transit porous laparoscopic cholecystectomy,postoperative anal exhaust time,postoperative hospital stay,postoperative pain degree,use of analgesic drugs ratios and postoperative complications.Results The operation time of the experimental group and the control group was(36.31±10.52)min and(58.84±14.57)min,and the difference was statistically significant(t=4.762,P=0.000).The Calot triangle showed good results:the experimental group accounted for 96.00%,the control group accounted for 62.79%,and the difference was statistically significant(χ^(2)=20.293,P=0.000).Postoperative Prince-Henry pain score:the experimental group was(1.22±0.20)and the control group was(2.58±0.18),and the difference was statistically significant(t=4.526,P=0.020).Postoperative analgesic drugs were used:8.00%in the experimental group and 30.23%in the control group,the difference was statistically significant(χ^(2)=9.228,P=0.000).In intraoperative blood loss,intraoperative transfer porous LC bed,the first time,anal exhaust time,average length of hospital stay and postoperative complications(such as bile leakage,infection of incision,increase of)differences of no statistical significance(P>0.05).Conclusion The method of"hanging line"in laparoscopic cholecystectomy was better for Calot triangle,shorter operation time,light postoperative pain,simple operation and easy to be popularized.

关 键 词：经脐单孔腹腔镜胆囊切除术 胆囊良性病变 吊线法 三器械法 

分 类 号：R575.6[医药卫生—消化系统]