摘要
目的探讨不同微创保胆取石术的临床疗效和对胆囊结石患者胆囊、肝功能及生活质量的影响。方法胆囊结石病人60例,根据治疗方式将其分为研究组和对照组,每组各30例。研究组采用腹腔镜联合胆道镜保胆取石术,对照组采用完全腹腔镜保胆取石术,比较两组病人临床疗效等指标差异。结果研究组有效率为96. 67%,对照组为93. 33%,两组比较差异无统计学意义(P> 0. 05);研究组手术时间长于对照组,且结石清除率高于对照组,而术中出血量少于对照组(P <0. 05),两组病人肠道功能恢复时间、术后住院时间及术后并发症发生率比较,差异无统计学意义(P> 0. 05);研究组病人术后12个月的空腹胆囊容积大于对照组,术后3个月和12个月的胆囊最大收缩率优于对照组(P <0. 05);两组病人术前肝功能指标比较无差异,但术后1天两组肝功能指标均有所上升且对照组上升程度大于研究组(P <0. 05),而术后1个月时,两组肝功能指标均降至术前水平,且差异无统计学意义(P> 0. 05);两组病人术后1年生活质量评分较术前明显改善,研究组更为显著(P <0. 05)。结论两种微创保胆取石术临床疗效相近,双镜联合保胆术更有利于保护病人胆囊及肝的功能。
Objective To study the curative effect,gallbladder,liver function and living quality between cholecystolithotomy with gallbladder reservation by laparoscopy and choledochoscope and laparoscopic cholecystectomy in gallbladder stone patients with colecystolithiasis. Methods 60 patients with gallbladder stone were selected and they were divided into research group（ n = 30） and control group（ n =30） according to different surgical operation way. Research group was treated by laparoscope combined with choledochoscope while control group was treated by totally laparoscope for gallbladder-protected lithotomy. The curative effect and so on were observed in the two groups. Results The curative effect between research group（ 96. 67%） and control group（ 93. 33%） which had no statistically significant difference（ P〉0. 05）. Operation time and removal rate of calculi in research group were obviously longer than that of control group,and blood loss wassignificantly less than that of control group,the difference was statistically significant（ P〈0. 05）,but two groups of intestinal peristalsis recovery time 、hospitalization days and postoperative complications had no statistically significant difference（ P〉0. 05）. The fasting gallbladder volume and maximum shrinkage 12 months after operation were better in the research group than those in the control group（ P〈0. 05）. The liver function in two groups had no statistically significant difference before and 1 month after operation（ P〉0. 05）. The living quality in in the research group were higher than the control group 12 month after operation（ P〈0. 05）. Conclusion Choledochoscope-assisted laparoscopic surgery for gallstones is safe and effective for the recovery of gallbladder and liver function,at the same time it can improve the living quality of patients,thus should be widely applied.
作者
张荣广
刘成菊
ZHANG Rongguang;LIU Chengju(Department of General Surgery,the First People＇s Hospital of Tancheng County,Linyi city,Shandong Province,Linyi 276199,China)
出处
《临床外科杂志》
2018年第9期696-698,共3页
Journal of Clinical Surgery
关键词
腹腔镜
胆道镜
胆囊结石
保胆取石术
laparoscope
choledochoscope
gallbladder stone
gallbladder-protected lithotomy
