腹腔镜胆总管切开取石一期缝合在胆总管结石中的应用效果  

Application Effect of Laparoscopic Choledochotomy and Quarrying One-stage Suture in the Choledocholithiasis

作　　者：宋留龙 崔恒锋[1] 吉巍巍 SONG Liulong;CUI Hengfeng;JI Weiwei(Yancheng Third People's Hospital,Yancheng 224001,China;不详)

机构地区：[1]盐城市第三人民医院,江苏盐城224001

出　　处：《中外医学研究》2023年第5期5-9,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析腹腔镜胆总管切开取石一期缝合在胆总管结石中的应用效果。方法:选取2019年1月—2021年12月盐城市第三人民医院收治的82例胆总管结石患者作为研究对象。根据随机数表法将其分为观察组和对照组,各41例。两组均给予腹腔镜胆总管切开取石术,观察组采用一期缝合,对照组采用T管引流。比较两组围手术期指标、术前和术后3 d炎症因子、肝功能指标,术前和术后6 h疼痛程度,并发症。结果:观察组肠道功能恢复时间早于对照组,手术时间和住院时间均短于对照组(P<0.05),两组术中出血量比较差异无统计学意义(P>0.05)。术后3 d,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均比术前低(P<0.05),观察组IL-6、CRP水平均低于对照组(P<0.05);术后6 h,两组视觉模拟评分法(visual analogue scale,VAS)评分均低于术前,观察组评分低于对照组(P<0.05)。术后3 d,两组丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬酸氨基转移酶(aspartate aminotransferase,AST)和总胆红素(total bilirubin,TBIL)水平均低于术前(P<0.05),观察组ALT、AST和TBIL水平均低于对照组(P<0.05)。观察组术后并发症发生率明显低于对照组(P<0.05)。结论:腹腔镜胆总管切开取石一期缝合治疗胆总管结石患者手术时间短,可促进术后肠道功能和肝功能恢复,缓解疼痛,改善机体炎症反应状态,效果和安全性较高。Objective: To analyze the application effect of laparoscopic choledochotomy and quarrying one-stage suture in the choledocholithiasis. Method: A total of 82 patients with choledocholithiasis admitted to Yancheng Third People’s Hospital from January 2019 to December 2021 were selected as the research objects. According to the random number table method, they were divided into observation group and control group, 41 cases in each group. Both groups were given the laparoscopic choledochotomy and quarrying, the observation group taken the one-stage suture, and the control group taken the T-tube drainage. The perioperative indicators, inflammatory factors and liver function indexes before and 3 d after operation, pain degree before and 6 h after operation, and complications were compared between the two groups. Result: The recovery time of intestinal function in the observation group was earlier than that in the control group, the operation time and hospital stay were shorter than those in the control group(P<0.05), and there was no significant difference in the amount of intraoperative blood loss between the two groups(P>0.05). At 3 d after operation, the levels of interleukin-6(IL-6) and C-reactive protein(CRP) in the two groups were lower than those before operation(P<0.05), and the levels of IL-6 and CRP in the observation group were lower than those in the control group(P<0.05). At 6 hours after operation, the scores of visual analogue scale(VAS) in the two groups were lower than those before operation, the observation group was lower than that in the control group(P<0.05).At 3 d after operation, the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and total bilirubin(TBIL) in the two groups were lower than those before operation(P<0.05), and the levels of ALT, AST and TBIL in the observation group were lower than those in the control group(P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05). Conclu

关 键 词：胆总管结石 腹腔镜 胆总管切开 一期缝合 并发症 效果 

分 类 号：R657.4[医药卫生—外科学]