摘要
目的:研究腹腔镜下胆道镜联合肾镜超声碎石取石在肝胆道结石患者中的应用及对机体创伤应激的影响。方法:方便选取2018年1月-2020年1月笔者所在医院收治的86例肝胆道结石患者作为研究对象,依据随机数字表法分为研究组和对照组,每组43例。对照组采用传统高位胆总管切开取石术取石,研究组采用腹腔镜下胆道镜联合肾镜超声碎石取石术取石,比较两组手术时长、术中出血量、术后残石率、肛门首次排气时间、术后进食时间、术后并发症发生情况及对创伤应激指标。结果:研究组手术时长短于对照组,术中出血量少于对照组,肛门首次排气时间、术后进食时间均早于对照组,差异均有统计学意义(P<0.05)。研究组术后残石率为4.65%,低于对照组的20.93%,差异有统计学意义(P<0.05)。术前两组Cor、肾上腺素、IL-6、TNF-α、空腹血糖比较差异无统计学意义(P>0.05),术后24 h研究组各指标水平均高于术前,差异均有统计学意义(P<0.05),术后48 h各指标水平与术前比较差异无统计学意义(P>0.05);对照组术后24、48 h各指标水平均高于术前,差异均有统计学意义(P<0.05);研究组术后相同时间点各应激指标水平均低于对照组,差异均有统计学意义(P<0.05)。研究组术后并发症发生率为4.65%,低于对照组的18.60%,差异有统计学意义(P<0.05)。结论:腹腔镜下胆道镜联合肾镜超声碎石取石术安全性高、效果显著,且机体创伤应激反应小,值得临床广泛推广。
Objective:To study the application of laparoscopic choledochoscope combined with nephroscope ultrasonic lithotripsy in patients with hepatolithiasis and the influence on traumatic stress.Method:A total of 86 patients with hepatolithiasis who were treated in our hospital from January 2018 to January 2020 were selected and divided into the study group and the control group by random number table method,with 43 cases in each group.The control group was treated with traditional high choledocholithotomy,and the study group was treated with laparoscopic choledochoscope combined with nephroscope ultrasonic lithotripsy.The operative duration,intraoperative blood loss,postoperative stone residual rate,first anal exhaust time,postoperative feeding time,postoperative complications and traumatic stress indexes were compared between the two groups.Result:The operation duration in the study group was shorter than that in the control group,the amount of intraoperative blood loss was less than that in the control group,the time of first anal exhaust and postoperative feeding time were earlier than that in the control group,the differences were statistically significant(P<0.05).The postoperative residual stone rate in the study group(4.65%)was lower than that in the control group(20.93%),the difference was statistically significant(P<0.05).There were no significant differences in Cor,epinephrine,IL-6,TNF-αand fasting plasma glucose between the two groups before operation(P>0.05),the levels of all indicators in the study group 24 h after operation were higher than those before operation,the differences were statistically significant(P<0.05),and there were no significant differences in the levels of all indicators 48 h after operation(P>0.05),the levels of all indexes in the control group 24 and 48 h after operation were higher than those before operation,the differences were statistically significant(P<0.05),the levels of stress indexes in the study group were lower than those in the control group at the same time point after operation,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group(4.65%)was lower than 18.60%in the control group(P<0.05).Conclusion:Laparoscopic choledochoscope combined with nephroscope ultrasonic lithotripsy is safe and effective,with mild traumatic stress response.
作者
王君
WANG Jun(Yulin First People’s Hospital,Yulin 537000,China)
出处
《中外医学研究》
2021年第5期72-75,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
腹腔镜
胆道镜
肾镜
肝胆道结石
创伤应激
Laparoscope
Choledochoscope
Nephroscope
Hepatolithiasis
Traumatic stress
