经脐单孔腹腔镜胆囊切除术对胆囊良性疾病的应用价值  

Application value of transumbilical single hole laparoscopic cholecystectomy for benign gallbladder diseases

作　　者：卢寅[1] 朱丽丹[1] 杜敏[1] 童钟[1] LU Yin;ZHU Lidan;DU Min;TONG Zhong(Department of General Surgery,the First People’s Hospital of Hefei,Hefei 230000,China)

机构地区：[1]合肥市第一人民医院普外科,安徽合肥230000

出　　处：《安徽医学》2023年第7期777-781,共5页Anhui Medical Journal

基　　金：安徽医科大学第三附属医院基础与临床合作研究提升计划培育专项(编号:2022sfy014)。

摘　　要：目的比较经脐单孔和传统三孔法腹腔镜胆囊切除术对胆囊良性疾病的疗效,探讨经脐单孔腹腔镜技术治疗胆囊良性疾病的价值。方法回顾性分析2020年6月至2021年6月合肥市第一人民医院微创外科收治的162例胆囊良性疾病患者,根据术式不同分为观察组79例(应用经脐单孔腹腔镜胆囊切除术)和对照组83例(应用三孔法腹腔镜胆囊切除术)。比较两组患者术中(手术时间、出血量)、术后(置管比例、排气及进食恢复时间、用止痛药次数、术后6 h、24 h、72 h切口疼痛评分,切口美观满意度、住院时间、住院费用)指标,其中疼痛评分通过视觉模拟量表(VAS)评估,切口美观满意度通过美容视觉模拟量表(CVAS)评估。结果观察组手术时间、CVAS评分高于对照组(P均<0.05);观察组术中出血量、术后置管比例低于对照组(P=0.001、0.009);观察组术后排气及进食恢复时间短于对照组(P均<0.05);观察组术后用止痛药次数少于对照组(P=0.003),两组患者术后VAS评分存在时间及交互效应(P<0.05);观察组住院时间、住院费用短/低于对照组(P均<0.05)。结论经脐单孔腹腔镜胆囊切除术虽较三孔法腹腔镜手术延长了手术时间,但具有术中出血少,术后疼痛轻、恢复快、住院时间短、手术费用低、切口美观等优点。Objective To compare the efficacy of transumbilical single hole laparoscopic cholecystectomy with traditional three-hole laparoscopic cholecystectomy for benign gallbladder diseases,and to explore the value of transumbilical single hole laparoscopic technique for benign gallbladder diseases.Methods A total of 162 patients with benign gallbladder diseases admitted to the Minimally Invasive Surgery Department of the First People's Hospital of Hefei from June 2020 to June 2021 were retrospectively analyzed,and they were divided into the observation group(79 cases)and the control group(83 cases)according to different surgical methods.Intraoperative(time of operation,amount of blood loss),postoperative(catheterization ratio,recovery time of exhaust and feeding,number of times of use of painkillers,incision pain score 6 h、24 h、72 h after surgery,incision aesthetic satisfaction,length of stay,hospitalization cost)indexes of the two groups were compared,and pain score was evaluated by visual analog scale(VAS).Incision aesthetic satisfaction was assessed by aesthetic visual Analog Scale(CVAS).Results The operation time and CVAS score of the observation group were higher than those of the control group(P<0.05).The in-traoperative blood loss and postoperative catheterization ratio in the observation group were lower than those in the control group(P=0.001,0.009).The recovery time of postoperative exhaust and feeding in the observation group was shorter than that in the control group(P<0.05).The number of postoperative painkillers used in the observation group was less than that in the control group(P=0.003),and the postoperative VAS scores between the two groups were statistically significant,with time and interaction effects(P<0.05).The length of stay and the cost of stay of the observation group were shorter and less than those in the control group(P<0.05).Conclusions Compared with three-hole laparo-scopic cholecystectomy,transumbilical single-port laparoscopic cholecystectomy can prolong the operation time,but it has

关 键 词：胆囊结石 胆囊炎 胆囊息肉 经脐单孔腹腔镜胆囊切除术 常规器械 

分 类 号：R65[医药卫生—外科学]