摘要
目的:探讨腹腔镜联合胆道镜取石术治疗复杂性肝胆管结石的效果及对患者免疫功能、生活质量的影响。方法:选取2018年1月-2020年7月永州市中心医院收治的100例复杂性肝胆管结石患者,根据随机数字表法将患者分为观察组和对照组,每组50例。观察组给予腹腔镜联合胆道镜取石术,对照组给予开放手术。比较两组围手术期指标、免疫功能、生活质量评分及并发症发生情况。结果:两组取石成功率比较,差异无统计学意义(P>0.05)。观察组手术时间长于对照组,术中出血量少于对照组,肠道功能恢复时间、引流时间及住院时间均短于对照组,差异均有统计学意义(P<0.05)。术后3 d,观察组CD4^(+)、CD4^(+)/CD8^(+)水平均低于对照组,CD8^(+)水平高于对照组,差异均有统计学意义(P<0.05)。术后1个月,观察组生活质量评分高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜联合胆道镜取石术治疗复杂性肝胆管结石临床疗效显著,术后恢复快,对免疫功能影响小,提高生活质量,安全性高,值得临床推广。
Objective:To investigate the effect of laparoscopy combined with choledochoscopy lithotomy in the treatment of complex hepatolithiasis and its influence on immune function and quality of life.Method:A total of 100 patients with complex hepatolithiasis admitted to Yongzhou Central Hospital from January 2018 to July 2020 were selected,they were divided into observation group and control group according to random number table method,with 50 cases in each group.The observation group was treated with laparoscopy combined with choledochoscopy lithotomy,while the control group was treated with open surgery.Perioperative indexes,immune function,quality of life score and incidence of complications were compared between two groups.Result:There was no significant difference in the success rate of stone extraction between two groups(P>0.05).The surgical time in the observation group was longer than that in the control group,the amount of intraoperative blood loss in the observation group was less than that in the control group,and the recovery time of intestinal function,drainage time and hospitalization time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).3 d after surgery,the levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and CD8^(+)level in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).1 month after surgery,the quality of life scores in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of complication rate in the observation group was lower than those in the control group,the differences was statistically significant(P<0.05).Conclusion:Laparoscopy combined with choledochoscopy lithotomy is effective in the treatment of complex hepatolithiasis,with rapid postoperative recovery,little impact on immune function,improved quality of life and high safety,which is worthy of clinical promotion.
作者
唐彪
田俊杰
谢龙辉
何华日
TANG Biao;TIAN Junjie;XIE Longhui;HE Huari(Yongzhou Central Hospital,Hunan Province,Yongzhou 425000,China;不详)
出处
《中国医学创新》
CAS
2022年第17期111-114,共4页
Medical Innovation of China
基金
永州市2018年指导性科技计划项目(2018ZD37)。
关键词
腹腔镜
胆道镜
复杂性肝胆管结石
免疫功能
生活质量
Laparoscopy
Choledochoscopy
Complex hepatolithiasis
Immune function
Quality of life
