完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床研究
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摘要
目的探究完全腹腔镜下规则性左肝切除术对左肝胆管结石的治疗效果。方法方便选取2017年1月—2018年12月期间收治的80例左肝胆管结石患者作为研究对象,以随机数字表法将其分入对照组(40例)和研究组(40例),对照组采取传统开腹手术,研究组下去完全腹腔镜下规则性左肝切除术。比较两组的术中出血量、术后并发症发生率、肛门排气时间、下床时间、住院时间等指标。结果研究组的术后并发症发生率为5%,低于对照组20%的术后并发症发生率,差异有统计学意义(χ~2=4.114,P=0.043<0.05)。研究组术中出血量为(104.23±57.11)mL,少于对照组的(369.21±67.65)mL,差异有统计学意义(t=18.929,P=0.000<0.05);研究组肛门排气时间、下床时间、住院时间分别为(1.92±0.13)d、(2.30±0.15)d、(10.62±2.12)d,短于对照组的(3.98±0.36)d、(4.98±0.27)d、(16.08±5.26)d,差异有统计学意义(t=34.039,54.877,6.089,P=0.000<0.05)。结论完全腹腔镜下规则性左肝切除术对左肝胆管结石有显著治疗效果,其创伤更小,并发症少,更有利于患者术后生理功能恢复,可使患者更快地恢复健康。
Objective To investigate the therapeutic effect of complete laparoscopic regular left hepatectomy on left hepatolithiasis. Methods Eighty patients with left hepatolithiasis admitted from January 2017 to December 2018 were convenient selected and enrolled in the study. They were randomly divided into the control group(40 cases) and the study group(40 cases). Traditional laparotomy was performed and the study group underwent complete laparoscopic regular left hepatectomy.The intraoperative blood loss, postoperative complication rate, anal exhaust time, bedtime, hospital stay and other indicators were compared between the two groups. Results The incidence of postoperative complications in the study group was 5%,which was lower than that in the control group(20%). The difference was statistically significant(χ2=4.114, P=0.043<0.05).The intraoperative blood loss of the study group was(104.23 ±57.11) m L, which was less than that of the control group(369.21 ±67.65) mL. The difference was statistically significant(t =18.929, P =0.000 <0.05). The anus exhaust time of the study group, the time of bedtime and hospital stay were(1.92±0.13)d,(2.30±0.15)d,(10.62±2.12)d, and shorter than the control group(3.98±0.36)d,(4.98±0.27)d,(16.08±5.26)d, the difference was statistically significant(t=34.039, 54.877, 6.089,P=0.000<0.05). Conclusion Complete laparoscopic regular left hepatectomy has significant therapeutic effect on left hepatolithiasis. It has less trauma and less complications. It is more conducive to the recovery of postoperative physiological function and can make patients recover health more quickly.
Objective To investigate the therapeutic effect of complete laparoscopic regular left hepatectomy on left hepatolithiasis. Methods Eighty patients with left hepatolithiasis admitted from January 2017 to December 2018 were convenient selected and enrolled in the study. They were randomly divided into the control group(40 cases) and the study group(40 cases). Traditional laparotomy was performed and the study group underwent complete laparoscopic regular left hepatectomy.The intraoperative blood loss, postoperative complication rate, anal exhaust time, bedtime, hospital stay and other indicators were compared between the two groups. Results The incidence of postoperative complications in the study group was 5%,which was lower than that in the control group(20%). The difference was statistically significant(χ2=4.114, P=0.043<0.05).The intraoperative blood loss of the study group was(104.23 ±57.11) m L, which was less than that of the control group(369.21 ±67.65) mL. The difference was statistically significant(t =18.929, P =0.000 <0.05). The anus exhaust time of the study group, the time of bedtime and hospital stay were(1.92±0.13)d,(2.30±0.15)d,(10.62±2.12)d, and shorter than the control group(3.98±0.36)d,(4.98±0.27)d,(16.08±5.26)d, the difference was statistically significant(t=34.039, 54.877, 6.089,P=0.000<0.05). Conclusion Complete laparoscopic regular left hepatectomy has significant therapeutic effect on left hepatolithiasis. It has less trauma and less complications. It is more conducive to the recovery of postoperative physiological function and can make patients recover health more quickly.
引文
[1]谢元才,叶荣强,钟鼎文,等.全腹腔镜与开腹规则性左肝切除术治疗肝胆管结石的比较研究[J].中国微创外科杂志,2017,17(5):397-401.
[2]黄建卿.规则与非规则性肝叶切除术治疗肝胆管结石的临床疗效比较[J].深圳中西医结合杂志,2017,27(3):12-14.
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[5]Zhang Y,Huang J,Chen XM,et al.A Comparison of Laparoscopic Versus Open Left Hemihepatectomy for Hepatocellular Carcinoma[J].Surgical Laparoscopy Endoscopy&Percutaneous Techniques,2016,26(2):146.
[6]郭辉,宋劲松,胡杰.RHL和IRHL治疗肝胆管结石临床疗效[J].中国现代普通外科进展,2017,20(11):890.
[7]Jin RA,Wang Y,Yu H,et al.Total laparoscopic left hepatectomy for primary hepatolithiasis:Eight-year experience in a single center[J].Surgery,2016,159(3):834-841.
[8]Tsui WM,Chan YK,Wong CT,et al.Hepatolithiasis and the syndrome of recurrent pyogenic cholangitis:clinical,radiologic,and pathologic features[J].Seminars in Liver Disease,2011,31(1):33-48.
[9]徐献忠.肝胆管结石采用腹腔镜规则性肝叶切除术的可行性及安全性分析[J].现代诊断与治疗,2017,28(11):2090-2091.
[10]谭文.规则与非规则肝叶切除治疗肝胆管结石疗效对比分析[J].中国现代药物应用,2016,10(17):60-61.
[11]顾永芳,王伟,程先硕.规则与非规则性肝叶切除术治疗肝胆管结石疗效与安全性观察[J].昆明医科大学学报,2015,36(12):29-32.
[12]张献毅.规则和非规则性肝叶切除术治疗肝胆管结石病患者的效果分析[J].中国普通外科杂志,2015,24(7):1050-1053.
[13]和红春,杜锐锋,张冰,等.规则性肝切除治疗肝胆管结石[J].云南医药,2014,35(2):194-196.
[14]祝晓云.完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床效果观察[J].中国实用医药,2018,13(36):61-62.
[15]贺德龙,周为,薛长梅,等.完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床研究[J].中华普外科手术学杂志:电子版,2018,12(5):448-450.
[2]黄建卿.规则与非规则性肝叶切除术治疗肝胆管结石的临床疗效比较[J].深圳中西医结合杂志,2017,27(3):12-14.
[3]Namgoong JM,Kim KH,Park GC,et al.Comparison of Laparoscopic Versus Open Left Hemihepatectomy for LeftSided Hepatolithiasis[J].International Journal of Medical Sciences,2014,11(2):127-133.
[4]祝立刚,何彦安.规则性肝段(叶)切除治疗肝胆管结石的临床分析[J].临床医药文献电子杂志,2018,5(39):70.
[5]Zhang Y,Huang J,Chen XM,et al.A Comparison of Laparoscopic Versus Open Left Hemihepatectomy for Hepatocellular Carcinoma[J].Surgical Laparoscopy Endoscopy&Percutaneous Techniques,2016,26(2):146.
[6]郭辉,宋劲松,胡杰.RHL和IRHL治疗肝胆管结石临床疗效[J].中国现代普通外科进展,2017,20(11):890.
[7]Jin RA,Wang Y,Yu H,et al.Total laparoscopic left hepatectomy for primary hepatolithiasis:Eight-year experience in a single center[J].Surgery,2016,159(3):834-841.
[8]Tsui WM,Chan YK,Wong CT,et al.Hepatolithiasis and the syndrome of recurrent pyogenic cholangitis:clinical,radiologic,and pathologic features[J].Seminars in Liver Disease,2011,31(1):33-48.
[9]徐献忠.肝胆管结石采用腹腔镜规则性肝叶切除术的可行性及安全性分析[J].现代诊断与治疗,2017,28(11):2090-2091.
[10]谭文.规则与非规则肝叶切除治疗肝胆管结石疗效对比分析[J].中国现代药物应用,2016,10(17):60-61.
[11]顾永芳,王伟,程先硕.规则与非规则性肝叶切除术治疗肝胆管结石疗效与安全性观察[J].昆明医科大学学报,2015,36(12):29-32.
[12]张献毅.规则和非规则性肝叶切除术治疗肝胆管结石病患者的效果分析[J].中国普通外科杂志,2015,24(7):1050-1053.
[13]和红春,杜锐锋,张冰,等.规则性肝切除治疗肝胆管结石[J].云南医药,2014,35(2):194-196.
[14]祝晓云.完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床效果观察[J].中国实用医药,2018,13(36):61-62.
[15]贺德龙,周为,薛长梅,等.完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床研究[J].中华普外科手术学杂志:电子版,2018,12(5):448-450.