胆囊结石继发胆总管结石应用腹腔镜微创手术治疗的效果探讨  

Effect of minimally invasive laparoscopic surgery for gallbladder stones and common bile duct stones

作　　者：马福军 MA Fu-jun(Emergency Department,Chaoyang Second Hospital,Chaoyang 122000,China)

机构地区：[1]辽宁省朝阳市第二医院急诊科,122000

出　　处：《中国实用医药》2022年第17期61-63,共3页China Practical Medicine

摘　　要：目的 探讨胆囊结石继发胆总管结石(GCBDS)应用腹腔镜微创手术治疗的临床效果。方法 90例GCBDS患者,按照随机抽签法分为对照组和观察组,各45例。对照组患者接受传统开腹切开胆总管取石术和胆囊切除术治疗,观察组患者接受腹腔镜微创手术(内镜括约肌切开胆总管取石术和腹腔镜胆囊切除术)治疗。对比两组手术指标(手术时间、术后排气时间、术后排便时间、住院时间)、生活质量及并发症发生率。结果 观察组手术时间(107.2±17.6)min、术后排气时间(27.4±10.6)h、术后排便时间(42.1±10.9)h、住院时间(6.5±1.8)d均短于对照组的(144.2±20.3)min、(52.6±11.4)h、(84.3±11.5)h、(12.2±1.5)d,差异有统计学意义(P<0.05)。观察组躯体功能、生理功能、心理功能、社会功能评分分别为(23.5±1.4)、(22.6±1.2)、(23.1±1.7)、(22.9±1.5)分,均高于对照组的(17.3±2.6)、(16.5±2.5)、(15.4±2.8)、(16.9±2.6)分,差异有统计学意义(P<0.05)。观察组并发症发生率为6.7%,与对照组的20.0%对比差异无统计学意义(P>0.05)。结论 应用腹腔镜微创手术治疗GCBDS能够缩短康复时间,减少并发症发生率,还可有效提升患者的生活质量,值得临床积极推广应用。Objective To discuss the clinical effect of minimally invasive laparoscopic surgery for gallbladder stones and common bile duct stones(GCBDS).Methods A total of 90 cases of GCBDS patients were randomly divided into control group and observation group,with 45 cases in each group.Patients in the control group received traditional laparotomy and cholecystectomy,while patients in the observation group received minimally invasive laparoscopic surgery(endoscopic sphincterotomy and laparoscopic cholecystectomy).The surgical indicators(operation time,postoperative exhaust time,postoperative defecation time,hospitalization time),quality of life and complication rates were compared between the two groups.Results In the observation group,the operation time was(107.2±17.6)min,the postoperative exhaust time was(27.4±10.6)h,the postoperative defecation time was(42.1±10.9)h,and the hospitalization time was(6.5±1.8)d,which were all shorter than(144.2±20.3)min,(52.6±11.4)h,(84.3±11.5)h,and(12.2±1.5)d in the control group,and the differences were statistically significant(P<0.05).The scores of physical function,physiological function,psychological function and social function in the observation group were(23.5±1.4),(22.6±1.2),(23.1±1.7),and(22.9±1.5)points,which were higher than(17.3±2.6),(16.5±2.5),(15.4±2.8),and(16.9±2.6)points in the control group,and the differences were statistically significant(P<0.05).The complication rate in the observation group was 6.7%,and there was no statistically significant difference compared with 20.0%in the control group(P>0.05).Conclusion Minimally invasive laparoscopic surgery for the treatment of GCBDS can shorten the recovery time,reduce the complication rate,and effectiveness promote the quality of life of patients,which is worthy of actively promotion and application in clinical practice.

关 键 词：腹腔镜微创手术 胆囊结石 继发胆总管结石 

分 类 号：R657.4[医药卫生—外科学]