腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石临床疗效及术后恢复的影响  

Clinical Efficacy and Influence of Postoperative Recovery of Laparoscopic Combined Choledochoscopic Surgery in the Treatment of Cholecystolithiasis Complicated with Common Bile Duct Stones

作　　者：殷生亮 郭成 牛丽璇 戴群英 高源[1] Yin Sheng-liang;Guo Cheng;Niu Li-xuan;Dai Qun-ying;Gao Yuan(Red Star Hospital,13th Division,Xinjiang Production and Construction Corps,Hami 839000,Xinjiang,China)

机构地区：[1]新疆生产建设兵团第十三师红星医院,新疆哈密839000

出　　处：《中外医药研究》2022年第4期51-53,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析在胆囊结石合并胆总管结石患者的临床治疗中采取腹腔镜联合胆道镜手术治疗的临床效果及对患者术后恢复的影响。方法:回顾性分析2019年1月-2021年4月在新疆生产建设兵团第十三师红星医院收治的胆囊结石合并胆总管结石30例患者的临床资料,根据治疗方式不同分成对照组与观察组,各15例。对照组实施传统开腹手术,观察组实施腹腔镜联合胆道镜手术。观察两组患者手术相关指标、术后疼痛程度、术后并发症、结石残留率及炎性指标。结果:观察组术中出血量、排气时间以及住院天数指标低于对照组,观察组术后24 h、48 h以及72 h的视觉模拟疼痛评分低于对照组,观察组并发症发生率与结石残留率低于对照组,观察组术后第2天的白细胞计数、中性粒细胞比例、C反应蛋白水平低于对照组,差异具有统计学意义(P<0.05)。结论:腹腔镜与胆道镜手术联合治疗胆囊结石合并胆总管结石患者,效果显著,在有效清除结石的同时,利于降低术后并发症发生概率,手术创伤小,对缓解患者的术后疼痛,缩短排气时间、住院天数,缓解炎性反应等均有重要意义。Objective:To analyze the clinical effect of laparoscopy combined with choledochoscopy in the clinical treatment of patients with cholecystolithiasis combined with common bile duct stones and its influence on postoperative recovery.Methods:From January 2019 to April 2021,the clinical data of 30 patients with cholecystolithiasis combined with common bile duct stones who were admitted to the Red Star Hospital of the 13th Division of Xinjiang Production and Construction Corps were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,15 cases in each.The control group underwent traditional laparotomy,and the observation group underwent laparoscopy combined with choledochoscopy.The operation-related indexes,postoperative pain degree,postoperative complications,residual stone rate and inflammatory indexes of the two groups were observed.Results:The indexes of intraoperative blood loss,exhaust time and length of hospital stay in the observation group were lower than those in the control group.The visual analog pain scores of the observation group at 24 h,48 h and 72 h after operation were lower than those of the control group.The incidence of complications and residual stones in the observation group were lower than those in the control group.The white blood cell count,the proportion of neutrophils and the level of C-reactive protein in the observation group on the second day after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Laparoscopy combined with choledochoscopy in the treatment of patients with cholecystolithiasis and common bile duct stones has a significant effect;while effectively removing stones,it is beneficial to reduce the probability of postoperative complications,and the surgical trauma is small,which is of great significance for alleviating postoperative pain,shortening exhaust time,hospitalization days,and alleviating inflammatory reactions.

关 键 词：胆囊结石 胆总管结石 腹腔镜 胆道镜 

分 类 号：R65[医药卫生—外科学]