腹腔镜下胆管空肠Roux-en-Y吻合术治疗良性胆肠吻合口狭窄的疗效  

Clinical Efficacy of Laparoscopic Roux-en-Y Cholangiojejunostomy for Benign Bilioenteric Anastomotic Strictures

作　　者：于晶 吴姗姗 齐博[1] Yu Jing;Wu Shanshan;Qi Bo(Department of Cardiac Surgery,Nanyang Central Hospital,Nanyang,Henan,473000,China)

机构地区：[1]南阳市中心医院心脏外科,河南南阳473000

出　　处：《黑龙江医学》2024年第20期2476-2479,共4页Heilongjiang Medical Journal

摘　　要：目的:探究腹腔镜下胆管空肠Roux-en-Y吻合术治疗良性胆肠吻合口狭窄(BBEAS)的临床疗效。方法:选取2019年6月—2023年1月南阳市中心医院收治的100例胆肠吻合术后BBEAS患者作为研究对象,根据不同手术方法分为开放组和腹腔镜组,每组各50例。比较两组患者手术前后的实验室指标[总胆红素(TBIL)、直接胆红素(DBil)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷胺酰转肽酶(γ-GT)、C-反应蛋白(CRP)]水平、术中和术后情况以及不良反应发生率。结果:治疗后,腹腔镜组患者CRP水平显著低于开放组患者,差异有统计学意义(t=3.802,P<0.05);腹腔镜组患者手术时间长于开放组患者,术中出血量少于开放组,术后排气时间、引流管拔除时间以及住院时间均短于开放组,差异有统计学意义(t=2.139、3.465、6.549、7.553、2.404,P<0.05);腹腔镜组患者术后不良反应发生率显著低于开放组患者,差异有统计学意义(χ^(2)=5.741,P<0.05)。结论:腹腔镜下行胆管空肠Roux-en-Y吻合术,能够有效降低BBEAS患者术后炎症反应,减少术中出血,缩短术后恢复时间,降低术后不良反应发生率。Objective:To explore the clinical efficacy of laparoscopic Roux-en-Y cholangiojejunostomy for benign bilioenteric anastomotic strictures.Methods:100 patients with benign bilioenteric anastomotic strictures in the hospital from June 2019 to January 2023 were enrolled,and classified into open group and laparoscopic group,with 50 cases in each group.Then the laboratory indexes[total bilirubin(TBIL),direct bilirubin(DBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-Glutamyl transpeptidase(γ-GT)and C-reactive protein(CRP)],intraoperative and postoperative indexes,and the incidence of adverse reactions were compared between two groups.Results:After treatment,the CRP level in laparoscopic group was significantly lower than that in open group,with statistically significant difference(t=3.802,P<0.05).The operation time in laparoscopic group was longer than that in open group,and the intraoperative blood loss was less than that in open group.The postoperative exhaust time,drainage tube removal time and hospital stay were shorter than that in open group,with statistically significant difference(t=2.139,3.465,6.549,7.553,2.404;P<0.05).The incidence of postoperative adverse reactions in laparoscopic group was significantly lower than that in open group,and the difference was statistically significant(χ^(2)=5.741,P<0.05).Conclusion Application of laparoscopic Roux-en-Y cholangiojejunostomy for benign bilioenteric anastomotic strictures can effectively attenuate the inflammation response,reduce the intraoperative blood loss,shorten the postoperative recovery time,and decrease the adverse reaction rate in patients.

关 键 词：良性胆肠吻合口狭窄 胆管空肠ROUX-EN-Y吻合术 临床疗效 

分 类 号：R541[医药卫生—心血管疾病]