腹腔镜与传统开腹手术治疗胆囊结石并肝外胆管结石的效果分析  

Effect Analysis of Laparoscopy and Traditional Laparotomy in the Treatment of Cholecystolithiasis Complicated with Extrahepatic Bile Duct Stones

作　　者：陈童[1] 庄宁[1] 刘斌[1] CHEN Tong;ZHUANG Ning;LIU Bin(The Second Division of General Surgery,Changqing District People's Hospital,Jinan,Shandong Province,250300 China)

机构地区：[1]济南市长清区人民医院普外科二区,山东济南250300

出　　处：《系统医学》2022年第17期134-137,共4页Systems Medicine

摘　　要：目的评估胆囊结石并肝外胆管结石患者应用腹腔镜与传统开腹手术治疗的效果。方法选择济南市长清区人民医院在2020年10月—2021年10月接诊的84例胆囊结石并肝外胆管结石患者,根据随机数表法分为对照组与观察组,各42例。对照组接受传统开腹手术治疗,观察组接受腹腔镜手术治疗,比较两组胆囊结石并肝外胆管结石患者的治疗效果。结果观察组治疗总有效率(97.62%)高于对照组,差异有统计学意义(χ^(2)=4.480,P=0.034)。观察组并发症(切口感染、胆漏、胆道出血、肺部感染)发生率(4.76%)低于对照组,差异有统计学意义(χ^(2)=6.222,P=0.012)。观察组术中出血量(36.96±5.52)mL低于对照组,观察组的术后禁食时间(2.11±0.21)d、肛门排气时间(1.55±0.05)d、住院时间(8.13±2.05)d短于对照组,差异有统计学意义(P<0.05)。观察组复发率(0.00%)低于对照组,差异有统计学意义(χ^(2)=4.487,P=0.034)。观察组白细胞计数(11.23±2.05)×10^(9)/L、C反应蛋白(40.46±6.69)mg/L和中性粒细胞百分率(78.52±5.61)%均小于对照组,差异有统计学意义(P<0.05)。结论胆囊结石并肝外胆管结石患者采用腹腔镜手术治疗的效果理想,值得推广。Objective To evaluate the effect of laparoscopy and traditional open surgery in patients with gallbladder stones and extrahepatic bile duct stones.Methods A total of 84 patients with cholecystolithiasis and extrahepatic bile duct stones admitted to Changqing District People's Hospital of Jinan from October 2020 to October 2021 were selected and divided into control group and observation group according to the random number table method,with 42 cases in each group.The control group received traditional laparotomy,and the observation group received laparoscopic surgery.The therapeutic effects of the two groups of patients with gallbladder stones and extrahepatic bile duct stones were compared.Results The total effective rate(97.62%)of the observation group was higher than that of the control group,the difference was statistically significant(χ^(2)=4.480,P=0.034).The incidence of complications(incision infection,bile leakage,bile duct hemorrhage,and pulmonary infection)in the observation group(4.76%)was lower than that in the control group,the difference was statistically significant(χ^(2)=6.222,P=0.012).The intraoperative blood loss of the observation group was(36.96±5.52)mL lower than that of the control group.The postoperative fasting time of the observation group was(2.11±0.21)d,anal exhaust time(1.55±0.05)d,and hospitalization time(8.13±2.05)d was shorter than the control group,the difference was statistically significant(P<0.05).The recurrence rate of the observation group(0.00%)was lower than that of the control group,the difference was statistically significant(χ^(2)=4.487,P=0.034).The white blood cell count(11.23±2.05)×10^(9)/L,C-reactive protein(40.46±6.69)mg/L and neutrophil percentage(78.52±5.61)%in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion The effect of laparoscopic surgery for patients with cholecystolithiasis and extrahepatic bile duct stones is ideal,which is worthy of promotion.

关 键 词：腹腔镜手术 传统开腹手术 胆囊结石 肝外胆管结石 并发症 复发率 

分 类 号：R521[医药卫生—内科学]