单向倒刺线在腹腔镜胆总管切开取石一期缝合术中的应用研究

发布时间：2018-05-07 00:34

本文选题：倒刺线 + 腹腔镜　；参考：《南昌大学》2015年硕士论文

【摘要】：研究背景和目的:近年来,伴随微创技术的不断发展,腹腔镜胆总管切开取石一期缝合术(LBEPS)已经成为治疗胆总管结石的常用方法,但由于该术式对腹腔镜技术要求高,大大限制了其开展。单向倒刺线是一种新型免打结可吸收缝合线,可免去手术中的打结环节以及促进腹腔镜缝合,目前已在妇产科、泌尿外科证明其有效性,但在普外科方面很少有报道。因此通过对比研究单向倒刺线与普通可吸收线,评价单向倒刺线(V-LOC)在腹腔镜胆总管切开取石一期缝合术中的的可行性、安全性以及应用效果。方法:回顾性分析我院在2013年1月到2014年12月期间根据标准选取的55例行腹腔镜胆总管切开取石一期缝合术患者,根据术中缝合线不同分为:单向倒刺线组(A组,23例),普通可吸收线组(B组,32例)。分别比较两组术中情况(手术时间、术中出血量)和术后情况(术后肠道功能恢复时间、胆漏发生率、术后住院时间以及相关并发症)。采用卡方检验分析患者术前一般资料及术后并发症情况,采用两样本比较t检验分析手术时间、术中出血量、术后肠道功能恢复时间、住院时间,使用SPSS 22.0统计软件进行计算,以α=0.05为检验水准。结果:1、一般情况:两组病人在年龄分布、性别比例、胆总管直径、胆总管结石直径、胆总管结石数目、总胆红素各项指标之间的差异均无统计学意义(P0.05);2、术中情况:两组病人在手术时间上差异有统计学意义,A组的手术时间明显少于B组(P0.05),A组和B组在术中出血量方面差异无统计学意义(P0.05)。3、术后情况:两组在术后肠道功能恢复时间、胆漏发生率、术后住院时间和其它并发症的组间差异无统计学意义(P0.05)。结论:1、单向倒刺线在腹腔镜胆总管切开取石一期缝合中是安全可行的,操作简便。2、在腹腔镜胆总管切开取石一期缝合中,单向倒刺线相对于普通可吸收线可以缩短手术时间,而且具有不增加胆漏发生率以及其它并发症等特点。
[Abstract]:Background and purpose: in recent years, with the continuous development of minimally invasive techniques, laparoscopic choledochotomy and primary stony suture (LBEPS) has become a common method for the treatment of choledocholithiasis. However, because of its high requirements for the laparoscopic technique, it has greatly restricted its development. The single reverse thread is a new type of non knot absorbable suture. In order to avoid the knot in the operation and promote the laparoscopic suture, it is now in the obstetrics and Gynecology, and the Department of Urology has proved its effectiveness, but there are few reports in the Department of general surgery. So by comparing the unidirectional and common absorbable lines, the V-LOC in the first stage suture of the laparoscopic choledochotomy is evaluated. Methods: a retrospective analysis of 55 cases of laparoscopic choledochotomy for primary suture from January 2013 to December 2014, according to the standard, was divided into one way (group A, 23 cases), common absorbable line group (group B, 32 cases). The two groups were compared. Cases (operation time, intraoperative bleeding volume) and postoperative conditions (postoperative recovery time of intestinal function, incidence of bile leakage, postoperative hospitalization time and related complications). The general data and postoperative complications were analyzed by chi square test, and two samples were used to compare the operation time, intraoperative bleeding and postoperative intestinal function by t test. Recovery time and hospitalization time were calculated with SPSS 22 statistical software, and alpha =0.05 was used as the test level. Results: 1, general situation: the two groups of patients were in age distribution, sex ratio, choledocholithiasis diameter, choledocholithiasis diameter, choledocholithiasis number and total bilirubin indexes, no statistical significance (P0.05); 2, intraoperative conditions: There was significant difference in the operation time between the two groups. The operation time of group A was significantly less than that of group B (P0.05). There was no significant difference between group A and B in the intraoperative bleeding (P0.05).3. The postoperative situation: the recovery time of intestinal function, the incidence of bile leakage, the time of postoperative hospitalization and other complications were not statistically significant. Significance (P0.05). Conclusion: 1, the unidirectional barb line is safe and feasible in the primary suture of laparoscopic choledochotomy, and it is easy to operate.2. In the first stage suture of the laparoscopic choledochotomy, the unidirectional barbed wire can shorten the operation time compared with the common absorbable line, and there is no increase in the incidence of bile leakage and other complications. Point.

【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

【引证文献】