腹腔镜联合胆道镜胆总管探查一期缝合术治疗胆囊结石并胆总管结石患者的临床效果  

Clinical Effect of Laparoscopic Combined Choledochoscopy with Primary Suture for Cholecystolithiasis in Patients with Choledochothiasis

作　　者：朱德强 ZHU Deqiang(Department of General Surgery,Xintai People’s Hospital,Tai’an 271200,China)

机构地区：[1]新泰市人民医院普外科,山东泰安271200

出　　处：《反射疗法与康复医学》2025年第7期109-111,115,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨胆囊结石并胆总管结石(GCBDS)患者采取腹腔镜联合胆道镜胆总管探查(LCBDE)一期缝合术取得的效果。方法选取2022年7月—2024年6月新泰市人民医院收治的110例GCBDS患者为研究对象,按照随机数字表法将其分为对照组和研究组,每组55例。两组均采用LCBDE治疗,在此基础上,对照组采用T管引流术治疗,研究组采用一期缝合术治疗。比较两组患者的临床相关指标、应激反应指标、一次胆道结石清除率、随访6个月时的复发率及术后并发症发生情况。结果研究组手术操作时间、离床活动时间、住院时间均短于对照组,组间差异有统计学意义(P<0.05);两组术中出血量比较,差异无统计学意义(P>0.05)。术后3 d,研究组肾上腺素、皮质醇指标均低于对照组,组间差异有统计学意义(P<0.05)。两组术后一次胆道结石清除率、随访6个月时的复发率、术后并发症发生率比较,组间差异无统计学意义(P>0.05)。结论LCBED一期缝合术治疗GCBDS可以缩短手术操作时间,加快术后康复速度,缓解患者的机体应激反应,具有临床应用价值。Objective To investigate the effect of laparoscopic combined choledochoscopic choledochotomy(LCBDE)primary suture in patients with cholecystolithiasis and choledochothiasis(GCBDS).Methods A total of 110 GCBDS patients admitted to Xintai People’s Hospital from July 2022 to June 2024 were selected as the research objects,according to random number table method,they were divided into a control group and a research group,with 55 cases in each group,both groups were treated with LCBDE,on this basis,the control group was treated with T-tube drainage,and the research group was treated with primary suture.The clinical indicators,stress response indicators,single biliary stone clearance rate,recurrence rate and occurrence of postoperative complications were compared between the two groups.Results The operation time,out of bed activity time and hospitalization time of the research group were shorter than those of the control group,and the differences between the groups were statistically significant(P<0.05);there was no significant difference in intraoperative blood loss between the two groups(P>0.05).At 3 days after operation,the indicators of adrenaline and cortisol in the research group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).There were no significant differences in the single biliary stone clearance rate,the recurrence rate and the incidence of postoperative complications after 6 months of follow-up between the two groups(P>0.05).Conclusion Primary suture with LCBED for GCBDS can shorten the operation time,speed up postoperative recovery and relieve the stress response of patients,which has clinical application value.

关 键 词：胆囊结石并胆总管结石 腹腔镜联合胆道镜胆总管探查术 一期缝合术 

分 类 号：R575.62[医药卫生—消化系统]