间断缝合与连续缝合固定T管引流术在腹腔镜下胆总管切开取石术患者中的应用效果  

Application of interrupted suture versus continuous suture for T-tube drainage in patients undergoing laparoscopiccholedocholithotomy

作　　者：周成 ZHOU Cheng(Department of General Surgery,Yancheng No.1 People's Hospital,Yancheng,Jiangsu 224000,China)

机构地区：[1]盐城市第一人民医院普通外科,江苏盐城224000

出　　处：《医药前沿》2025年第3期55-57,61,共4页Journal of Frontiers of Medicine

摘　　要：目的 观察腹腔镜下胆总管切开取石术中行间断缝合与连续缝合固定T管引流术的效果。方法 选取2022年3月—2023年2月盐城市第一人民医院接受腹腔镜胆总管切开取石术的68例患者,按照随机数字表法分为对照组和研究组,各34例。两组均接受腹腔镜胆总管切开取石术,对照组采取间断缝合,研究组采取连续缝合。记录并统计分析两组围术期相关指标、胆总管压力、肝功能、并发症的发生情况。结果 研究组胆总管缝合用时短于对照组,差异有统计学意义(P<0.05);术中失血量、肛门排气用时、住院时长与对照组比较,差异无统计学意义(P>0.05)。术后第1天、第3天、第7天两组患者的胆总管压力较术前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。术后两组患者的丙氨酸氨基转移酶、总胆红素、γ-谷氨酰基转移酶、天门冬氨酸氨基转移酶水平较术前无明显变化,且组间比较,差异无统计学意义(P>0.05)。研究组并发症总发生率(5.88%)低于对照组(23.53%),差异有统计学意义(P<0.05)。结论 在腹腔镜胆总管切开取石术中,采取连续缝合固定T管引流效果优于间断缝合,可缩短胆总管缝合时间,降低胆总管压力,减少胆漏等并发症的发生风险,且对肝功能无不良影响。Objective To observe the effect of interrupted suture versus continuous suture for T-tube drainage in laparoscopic choledocholithotomy.Methods A total of 68 patients who underwent laparoscopic choledocholithotomy at Yancheng No.1 People's Hospital from March 2022 to February 2023 were divided into the control group and the study group according to the random digital table method,with 34 cases in each group.Both groups received laparoscopic choledocholithotomy,with the control group underwent interrupted suture and the study group underwent continuous suture.Perioperative indicators,bile duct pressure,liver function,and the incidence of complications were recorded and statistically analyzed.Results The time of common bile duct suture in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in intraoperative blood loss,time to anal exhaust,and hospital stay between the two groups(P>0.05).The common bile duct pressure of the two groups on the 1 st,3 rd and 7 th day after operation was lower than that before operation,and the study group was lower than the control group,the difference was statistically significant(P<0.05).The total incidence of complications in the study group(5.88%)was lower than that in the control group(23.53%),and the difference was statistically significant(P<0.05).Conclusions In laparoscopic choledocholithotomy,continuous suture for T-tube drainage is superior to interrupted suture,as it can reduce the time required for bile duct suture,decrease bile duct pressure,and reduce the risk of complications such as bile leakage,without adversely affecting liver function.

关 键 词：腹腔镜 胆总管切开取石术 间断缝合 连续缝合 T管引流 胆总管结石 肝功能 围手术期 

分 类 号：R61[医药卫生—外科学]