腹腔镜胆道镜联合治疗胆结石的效果及对胆囊功能的影响  

Effect of Laparoscopic Choledochoscopy in the Treatment of Gallstones and its Effect on Gallbladder Function

作　　者：曹海仁 CAO Hai-ren(Surgery Department of Yugan Maternal and Child Health Hospital,Yugan 335100,Jiangxi,China)

机构地区：[1]余干县妇幼保健院外科,江西余干335100

出　　处：《医学信息》2023年第21期98-101,共4页Journal of Medical Information

摘　　要：目的观察腹腔镜胆道镜联合治疗胆结石的效果及对胆囊功能的影响。方法选取2021年5月-2022年5月在我院诊治的76胆结石患者为研究对象,采用随机数字表法分为对照组(38例)和观察组(38例),对照组采用传统开腹术治疗,观察组采用腹腔镜胆道镜联合治疗。比较两组结石清除率、临床手术指标(手术时间、术中出血量、胃肠功能恢复时间、住院时间)、胆囊功能指标(胆囊最大收缩率、胆囊剩余容积、空腹胆囊容积)、并发症发生率、疼痛(VAS)评分及复发率。结果观察组结石清除率为92.10%,与对照组的97.37%比较,差异无统计学意义(P>0.05);观察组手术时间与对照组比较,差异无统计学意义(P>0.05),观察组术中出血量、胃肠功能恢复时间、住院时间均小于对照组(P<0.05);观察组空腹胆囊容积与对照组比较,差异无统计学意义(P>0.05),观察组胆囊最大收缩率大于对照组,胆囊剩余容积小于对照组(P<0.05);观察组并发症发生率为5.26%,低于对照组的18.42%(P<0.05);观察组术后1 h VAS评分与对照组比较,差异无统计学意义(P>0.05),观察组术后6、12、24 h疼痛评分均低于对照组(P<0.05);随访3个月,观察组复发率低于对照组(P<0.05)。结论腹腔镜胆道镜联合治疗胆结石效果突出,可实现与传统开腹治疗相似的结石清除率,同时能减轻患者疼痛,降低复发率和并发症发生率,减少术中出血量,缩短术后胃肠功能恢复和住院时间,且可改善胆囊功能,具有良好的临床应用可行性、有效性以及安全性。Objective To observe the effect of laparoscopic choledochoscopy in the treatment of gallstones and its effect on gallbladder function.Methods A total of 76 patients with gallstones diagnosed and treated in our hospital from May 2021 to May 2022 were selected as the research objects.They were divided into control group(38 patients)and observation group(38 patients)by random number table method.The control group was treated with traditional laparotomy,and the observation group was treated with laparoscopic choledochoscopy.The stone clearance rate,clinical operation indexes(operation time,intraoperative blood loss,gastrointestinal function recovery time,hospitalization time),gallbladder function indexes(maximum gallbladder contraction rate,residual gallbladder volume,fasting gallbladder volume),complication rate,pain(VAS)score and recurrence rate were compared between the two groups.Results The stone clearance rate of the observation group was 92.10%,which was compared with 97.37%of the control group,the difference was not statistically significant(P>0.05);there was no significant difference in the operation time between the observation group and the control group(P>0.05).The intraoperative blood loss,gastrointestinal function recovery time and hospitalization time in the observation group were less than those in the control group(P<0.05).There was no significant difference in fasting gallbladder volume between the observation group and the control group(P>0.05).The maximum contraction rate of gallbladder in the observation group was higher than that in the control group,and the residual volume of gallbladder was lower than that in the control group(P<0.05).The incidence of complications in the observation group was 5.26%,which was lower than 18.42%in the control group(P<0.05).There was no significant difference in VAS score between the observation group and the control group at 1 h after operation(P>0.05).The pain scores of the observation group at 6,12 and 24 h after operation were lower than those of the control

关 键 词：腹腔镜 胆道镜 胆结石 胆囊功能 

分 类 号：R657.42[医药卫生—外科学]