腹腔镜下左肝外叶切除术对左肝外叶胆管结石患者肝功能及术后康复的影响  

Effect of laparoscopic left extrahepatic lobectomy on liver function and postoperative rehabilitation of patients with left extrahepatic bile duct stones

作　　者：朱剑彪[1] 涂江波 蒋遗云 ZHU Jianbiao;TU Jiangbo;JIANG Yiyun(The Second Department of General Surgery,Fengcheng People's Hospital,Yichun,Jiangxi,331100,China)

机构地区：[1]丰城市人民医院普外二科,江西宜春331100

出　　处：《当代医学》2023年第17期91-94,共4页Contemporary Medicine

摘　　要：目的探讨腹腔镜下左肝外叶切除术对左肝外叶胆管结石患者肝功能及术后康复的影响,为临床治疗左肝外叶胆管结石提供依据。方法选取2019年5月至2020年5月本院普外科收治的100例左肝外叶胆管结石患者作为研究对象,按手术方法不同分为对照组与研究组,每组50例。对照组接受开腹左肝外叶切除术治疗,研究组接受腹腔镜左肝外叶切除术治疗,比较两组两组围手术期相关指标、肝功能指标和不良反应发生情况。结果研究组手术时间长于对照组,术中出血量少于对照组,术后疼痛数字评分法(NRS)评分低于对照组,肠功能恢复时间和住院时间均短于对照组,差异有统计学意义(P<0.05);两组初次结石清除率和术后结石复发率比较差异无统计学意义。术前,两组血清白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)水平比较差异无统计学意义;术后3 d,两组ALT、ALB、TBIL水平均低于术前,但研究组ALT、ALB水平均高于对照组,差异有统计学意义(P<0.05),两组TBIL水平比较差异无统计学意义。研究组不良反应发生率为10.00%,低于对照组的26.00%,差异有统计学意义(P<0.05)。结论腹腔镜下左肝外叶切除术治疗左肝外叶胆管在清除结石方面与开腹手术相当,但能明显减轻患者术后疼痛,对肝功能的影响较小,不良反应较少,术后恢复更快,整体疗效优于开腹手术,值得临床推广应用。Objective To investigate the effects of laparoscopic left extrahepatic lobectomy on liver function and postoperative rehabilitation of patients with left extrahepatic duct stones,and to provide evidence for clinical treatment of left extrahepatic duct stones.Methods A total of 100 patients with left extrahepatic bile duct stones admitted to the department of General Surgery of our hospital from May 2019 to May 2020 were selected as the research subjects,and they were divided into the control group and the study group according to different surgical methods,with 50 cases in each group.The control group received open left extrahepatic lobectomy,and the study group received laparoscopic left extrahepatic lobectomy,the perioperative related indexes,liver function indexes and adverse reactions were compared between the two groups.Results The operation time in the study group was longer than that in the control group,the amount of intraoperative blood loss was less than that in the control group,the postoperative numerical rating scale(NRS)score was lower than that in the control group,the recovery time of intestinal function and the length of hospital stay were shorter than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the primary stone clearance rate and postoperative stone recurrence rate between the two groups.Before operation,there were no significant differences in serum albumin(ALB),alanine aminotransferase(ALT)and total bilirubin(TBIL)levels between the two groups;3 d after operation,the ALT,ALB and TBIL levels of two groups were lower than before operation,but ALT and ALB levels in the study group were higher than those in the control group,the difference was statistically significant(P<0.05),and there was no statistically significant difference in TBIL levels between the two groups.The incidence of adverse reactions in the study group was 10.00%,which was lower than 26.00%in the control group,and the difference was statistically signif

关 键 词：腹腔镜下左肝外叶切除术 开腹左肝外叶切除术 肝内胆管结石 左肝外叶胆管结石 

分 类 号：R657.4[医药卫生—外科学]