腹腔镜联合胆道镜治疗肝内外胆管结石的临床分析

发布时间：2018-06-05 04:33

本文选题：胆结石 + 内窥镜检查　；参考：《中华普外科手术学杂志(电子版)》2016年06期

【摘要】：目的探讨腹腔镜与胆道镜联合胆管切开取石术在肝内外胆管结石中的应用效果。方法选取2012年1月至2015年4月间的110例肝内外胆管结石患者为研究对象,将其按照随机数字表法分为腔镜、胆道镜联合组(联合组)与开腹组,两组各55例。采取SPSS 19.0统计学软件进行数据分析与处理,手术时间、术中出血量、肛门排气时间、住院时间计量资料采取均数±标准差(x±s)表示,采用t检验;术后并发症、残石率计数资料采取χ~2进行检验,P0.05为差异有统计学意义。结果联合组与开腹组患者手术时间、术中出血量、肛门排气时间和住院时间为(99.5±10.7)min比(132.6±12.7)min、(89.5±11.4)ml比(163.6±23.5)ml、(24.5±1.7)h比(85.2±8.3)h、(7.5±1.1)d比(12.7±2.7)d,差异有统计学意义(t=23.308,t=10.471,t=16.443,t=6.216,P0.05)。联合组比开腹组术后并发症发生率9.1%比20.0%,差异有统计学意义(χ~2=6.301,P0.05)。联合组比开腹组残石率10.9%比41.8%,差异有统计学意义(χ~2=4.682,P0.05)。结论临床中对于肝内外胆管结石患者实施腹腔镜与胆道镜联合治疗效果显著,属于微创手术,手术时间短,术中出血量少,术后恢复快,并发症相对较少,治疗安全性高,值得临床中应用与推广,实际应用价值高。
[Abstract]:Objective to evaluate the effect of laparoscopic choledochoscopy combined with choledocholithotomy in the treatment of intrahepatic and extrahepatic cholelithiasis. Methods 110 patients with intrahepatic and extrahepatic cholelithiasis from January 2012 to April 2015 were randomly divided into two groups: endoscopic group (combined group) and laparotomy group (55 cases in each group). The data were analyzed and processed by SPSS 19.0 statistical software. The measurement data of operation time, intraoperative bleeding volume, anal exhaust time and hospitalization time were expressed by mean 卤standard deviation (x 卤s), t test, postoperative complications, and postoperative complications. The count data of residual stone rate were statistically significant by 蠂 ~ 2 test (P0.05). Results the operative time, intraoperative blood loss, anal exhaust time and hospitalization time in the combined group and the open group were 99.5 卤10.7)min vs 132.6 卤12.7min, 89.5 卤11.4)ml vs 163.6 卤23.5ml / min, 24.5 卤1.7h vs 85.2 卤8.3hU / h, 7.5 卤1.1d vs 12.7 卤2.7d, respectively. The difference was statistically significant (P < 0.05). The incidence of postoperative complications in the combined group was 9.1% vs 20.0% compared with that in the open group, and the difference was statistically significant (蠂 2 + 6.301%, P 0.05). The residual stone rate of the combined group was 10.9% vs 41.8% compared with the open group, and the difference was statistically significant (蠂 ~ (2) 4.682) (P 0.05). Conclusion Laparoscopy combined with choledochoscopy is effective in the treatment of patients with intrahepatic and extrahepatic cholelithiasis. It is a minimally invasive operation, with less operative time, less intraoperative bleeding, faster postoperative recovery, less complications and higher safety in the treatment of choledocholithiasis. Worthy of clinical application and promotion, practical application value is high.
【作者单位】：湖北恩施土家族苗族自治州中心医院肝胆外科;武汉大学恩施临床学院;
【分类号】：R657.42

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