常规器械经脐单孔腹腔镜胆囊切除术的应用研究

发布时间：2018-11-21 07:32

【摘要】：研究目的:通过比较常规器械经脐单孔腹腔镜胆囊切除与三孔法腹腔镜胆囊切除术的手术疗效,和自制单孔腹腔镜手术操作套筒及手术技巧改进,探讨常规器械经脐单孔腹腔镜胆囊切除术的难点与安全性、局限性与可行性、及推广应用价值。研究方法:选择吉林市中心医院肝胆外科自2012年1月至2014年12月的常规器械经脐腹腔镜胆囊切除术51例为单孔组(A组),与一时期相同手术医师实行的三孔法腹腔镜胆囊切除术50例为对照组(B组),两组病例病人均为单纯胆囊炎或单纯胆囊结石的病人。比较两组手术中出血量、手术操作时间、术后排气时间、进食时间,术后住院时间,住院费用。研究结果:两组手术均按照计划顺利完成,单孔组与对照组相比,手术出血量无统计学差异(P0.05),手术时间对照组少于单孔组,有统计学意义(P0.05).但在术后排气时间,术后平均住院日,住院费用方面单孔组明显优于对照组(P0.001)。结论:常规器械经脐单孔腹腔镜与三孔法腹腔镜胆囊切除术相对比,具有术后疼痛轻、恢复快、腹部疤痕不明显且隐蔽等优点,是安全可靠的,且由于应用了常规腹腔镜手术器械代替专业的单孔腹腔镜手术器械,及以自制的单孔多通道装置代替市场上昂贵的单孔三通道装置,极大地减少了手术成本,这使得单孔腹腔镜胆囊切除术,摆脱了对专业单孔手术器械及单孔三通道装置的依赖,在我国经济还不十分发达的现阶段,使该术式具有极强的推广应用价值。
[Abstract]:Objective: to compare the effect of laparoscopic cholecystectomy (LC) with conventional instruments and laparoscopic cholecystectomy (LC) with three-hole laparoscopic cholecystectomy (LC). To discuss the difficulty, safety, limitation and feasibility of laparoscopic cholecystectomy through umbilical single hole, and the value of popularization and application. Methods: from January 2012 to December 2014, 51 cases of laparoscopic cholecystectomy with routine instruments from January 2012 to December 2014 in Jilin City Central Hospital were selected as single hole group (group A). Fifty cases of laparoscopic cholecystectomy with three holes were used as control group (group B) and two groups of patients were patients with simple cholecystitis or simple cholecystolithiasis. The blood loss, operation time, postoperative exhaust time, feeding time, postoperative hospitalization time and hospitalization cost were compared between the two groups. Results: the two groups were successfully completed according to the plan, the single hole group and control group, there was no statistical difference in the amount of operative bleeding (P0.05), the operation time in the control group was less than that in the single hole group, there was statistical significance (P0.05). However, the single hole group was significantly better than the control group in terms of postoperative exhaust time, average hospital stay and hospitalization cost (P0.001). Conclusion: compared with laparoscopic cholecystectomy with three holes, conventional instruments have the advantages of less pain, faster recovery, less visible and concealed abdominal scar and so on, which are safe and reliable. Due to the use of conventional laparoscopic instruments instead of professional single-hole laparoscopic instruments, and the use of self-made single-hole multi-channel devices instead of expensive single-hole three-channel devices on the market, the cost of surgery has been greatly reduced. This makes single-hole laparoscopic cholecystectomy get rid of the dependence on professional single-hole surgical instruments and single-hole three-channel devices. At the present stage when the economy of our country is not very developed the operation has a strong value of popularization and application.
【学位授予单位】：佳木斯大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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