腹腔镜胆总管切开纤维胆道镜取石胆总管一期缝合治疗胆总管结石患者的效果及对临床指标的影响  

Effect of laparoscopic common bile duct incision,choledochofiberscope lithotomy and common bile duct primary suture in the treatment of patients with common bile duct stones and its influences on clinical indicators

作　　者：李波 张怀东 孙智国 LI Bo;ZHANG Huaidong;SUN Zhiguo(General Surgery Department,Zhen'an Hospital,Shangluo 711500;General Surgery Department,the Third Hospital of Yulin,Yulin 719000;General Surgery Department,Fufeng People's Hospital,Baoji 722200,China)

机构地区：[1]镇安县医院普外科,陕西商洛711500 [2]榆林市第三医院普外科,陕西榆林719000 [3]扶风县人民医院普外科,陕西宝鸡722200

出　　处：《临床医学研究与实践》2024年第8期76-80,共5页Clinical Research and Practice

摘　　要：目的分析腹腔镜胆总管切开纤维胆道镜取石胆总管一期缝合治疗胆总管结石患者的效果及对临床指标的影响。方法选取2020年1月至2022年9月收治的90例胆总管结石患者为研究对象,以随机法将其分为常规组(n=45,腹腔镜胆总管切开纤维胆道镜取石T管引流术)和观察组(n=45,腹腔镜胆总管切开纤维胆道镜取石胆总管一期缝合治疗)。比较两组的治疗效果。结果观察组的手术时长、肠鸣音恢复时间、引流管留置时长、卧床时长及住院时长短于常规组,术中出血量低于常规组(P<0.05);两组的结石清除率比较,差异无统计学意义(P>0.05)。观察组术后住院期的并发症总发生率低于常规组(P<0.05)。术后,观察组的总胆红素(TBIL)、间接胆红素(IBIL)及直接胆红素(DBIL)水平低于常规组,白蛋白(ALB)、血红蛋白(Hb)及总蛋白(TP)水平高于常规组(P<0.05)。术后,观察组的β-内咖肽(β-EP)、神经肽Y(NPY)、肾上腺素(E)、皮质醇(Cor)及C肽(CP)水平均低于常规组(P<0.05)。结论腹腔镜胆总管切开纤维胆道镜取石胆总管一期缝合治疗胆总管结石患者可取得理想效果。Objective To analyze the effect of laparoscopic common bile duct incision,choledochofiberscope lithotomy and common bile duct primary suture in the treatment of patients with common bile duct stones and its influences on clinical indicators.Methods A total of 90 patients with common bile duct stones admitted from January 2020 to September 2022 were selected as the research objects.The patients were randomly divided into conventional group(n=45,laparoscopic common bile duct incision,fiber choledochoscope lithotomy and T tube drainage)and observation group(n=45,laparoscopic common bile duct incision,choledochofiberscope lithotomy and common bile duct primary suture).The therapeutic effects of the two groups were compared.Results The operation time,bowel sound recovery time,drainage tube indwelling time,bed time and hospitalization time of the observation group were shorter than those of the conventional group,and the intraoperative blood loss was lower than that of the conventional group(P<0.05);there was no significant difference in stone clearance rate between the two groups(P>0.05).The total incidence of postoperative complications in the observation group was lower than that in the conventional group(P<0.05).After operation,the levels of total bilirubin(TBIL),indirect bilirubin(IBIL)and direct bilirubin(DBIL)in the observation group were lower than those in the conventional group,and the levels of albumin(ALB),hemoglobin(Hb)and total protein(TP)were higher than those in the conventional group(P<0.05).After operation,the levels of β-endorphin(β-EP),neuropeptide Y(NPY),epinephrine(E),cortisol(Cor)and C-peptide(CP)in the observation group were lower than those in the conventional group(P<0.05).Conclusion Laparoscopic common bile duct incision,choledochofiberscope lithotomy and common bile duct primary suture in the treatment of patients with common bile duct stones can achieve ideal results.

关 键 词：胆总管结石 腹腔镜胆总管切开 纤维胆道镜取石 胆总管一期缝合术 T管引流术 

分 类 号：R657.4[医药卫生—外科学]