腹腔镜胆囊切除联合胆总管切开胆道镜取石T管引流术治疗胆囊结石并胆总管结石的效果分析
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摘要
目的分析胆囊结石合并胆总管结石临床治疗期间腹腔镜胆囊切除术、胆总管切开胆道镜取石T管引流术的联合应用效果。方法方便选择该院于2018年3—12月期间收治的胆囊结石合并胆总管结石患者62例,患者经过计算机随机分组的方式划分为观察组(31例患者)与对照组(31例患者),对照组患者接受传统开腹术治疗,观察组患者接受腹腔镜胆囊切除术+胆总管切开胆道镜取石T管引流术治疗,对比两组患者的手术时间、腹腔引流时间、肠道恢复时间以及住院时间。结果观察组患者的手术时间为(122.34±51.34)min,腹腔引流时间为(2.34±0.67)d,肠道功能恢复时间(31.78±4.89)h,住院时间为(4.12±4.34)d;对照组患者的手术时间为(174.43±79.76)min,腹腔引流时间为(4.09±1.09)d,肠道功能恢复时间(44.32±10.12)h,住院时间为(8.54±2.76)d;比对组间数据,观察组患者优势显著,差异有统计学意义(t=4.057,7.615,6.212,4.785,P<0.05)。结论对胆囊结石合并胆总管结石患者行腹腔镜胆囊切除术、胆总管切开胆道镜取石T管引流术治疗,临床效果确切,而且可以缩短患者的康复周期,具有临床普及使用价值。
Objective To analyze the combined effect of laparoscopic cholecystectomy and common bile duct choledochoscopy with T-tube drainage during clinical treatment of gallbladder complicated with common bile duct stones. Methods Sixty-two patients with gallbladder and common bile duct stones admitted to our hospital from March to December 2018 were convenient selected and enrolled. The patients were randomly divided into observation group(31 patients) and control group(31 patients). Patients in the control group underwent conventional laparotomy. Patients in the observation group underwent laparoscopic cholecystectomy plus common bile duct choledochoscopy and T-tube drainage. The operation time,abdominal drainage time, and intestinal recovery time and hospital stay were compared between the two groups. Results The operation time of the observation group was(122.34±51.34)min, the drainage time of the abdominal cavity was(2.34±0.67)d, the recovery time of intestinal function was(31.78±4.89)h, and the hospitalization time was(4.12±4.34)d. In the control group, the operation time was(174.43±79.76)min, the drainage time of the abdominal cavity was(4.09±1.09)d, the recovery time of intestinal function was(44.32±10.12)h, and the hospitalization time was(8.54±2.76)d. It showed that patients in the observation group had significant advantages, and the difference was statistically significant(t=4.057, 7.615, 6.212,4.785, P <0.05). Conclusion In the treatment for patients with gallbladder complicated with common bile duct stones, laparoscopic cholecystectomy and common bile duct incision choledochoscopy with T-tube drainage have a clear clinical effect, which can shorten the recovery period of patients. It has clinical popularization value.
Objective To analyze the combined effect of laparoscopic cholecystectomy and common bile duct choledochoscopy with T-tube drainage during clinical treatment of gallbladder complicated with common bile duct stones. Methods Sixty-two patients with gallbladder and common bile duct stones admitted to our hospital from March to December 2018 were convenient selected and enrolled. The patients were randomly divided into observation group(31 patients) and control group(31 patients). Patients in the control group underwent conventional laparotomy. Patients in the observation group underwent laparoscopic cholecystectomy plus common bile duct choledochoscopy and T-tube drainage. The operation time,abdominal drainage time, and intestinal recovery time and hospital stay were compared between the two groups. Results The operation time of the observation group was(122.34±51.34)min, the drainage time of the abdominal cavity was(2.34±0.67)d, the recovery time of intestinal function was(31.78±4.89)h, and the hospitalization time was(4.12±4.34)d. In the control group, the operation time was(174.43±79.76)min, the drainage time of the abdominal cavity was(4.09±1.09)d, the recovery time of intestinal function was(44.32±10.12)h, and the hospitalization time was(8.54±2.76)d. It showed that patients in the observation group had significant advantages, and the difference was statistically significant(t=4.057, 7.615, 6.212,4.785, P <0.05). Conclusion In the treatment for patients with gallbladder complicated with common bile duct stones, laparoscopic cholecystectomy and common bile duct incision choledochoscopy with T-tube drainage have a clear clinical effect, which can shorten the recovery period of patients. It has clinical popularization value.
引文
[1]檀占海,朱光辉,陈建荣,等.腹腔镜胆囊切除术联合胆总管切开取石T管引流术治疗胆囊并胆总管结石的效果分析[J].临床肝胆病杂志,2017,33(5):883-887.
[2]蔡宇,何彦安.胆囊结石合并胆总管结石患者行腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发危险因素分析[J].肝胆外科杂志,2016,24(3):203-205.
[3]陈凯,苏洪德,巴音达拉.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的安全性[J].中外医学研究,2017,15(28):12-13.
[4]胡学斌,赵云青,刘斌.腹腔镜胆道镜联合钬激光治疗胆总管难取性结石的技术及效果分析[J].中外医学研究,2016,14(16):110-112.
[5]吕运海,张焕常,宋朝阳,等.腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发相关因素的Logistic回归分析[J].重庆医学,2016,45(9):1262-1264.
[6]梁刚,马富平,何盟国.腹腔镜联合胆道镜经胆囊管治疗胆囊结石合并胆总管结石的临床分析[J].临床肝胆病杂志,2017,33(11):2170-2172.
[7]游勤建,袁发秀,宋平.腹腔镜联合胆道镜与传统开腹手术治疗胆囊结石合并胆总管结石的疗效对比[J].河北医学,2016,22(5):721-724.
[8]王鹏,刘会东,阚永丰.全腹腔镜下联合胆道镜胆囊切除、胆总管切开探查取石Ⅰ期缝合的可行性研究[J].中国社区医师,2016,32(14):67.
[9]兰淑.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的护理体会[J].心理医生,2017,23(4):167-168.
[10]杨冠宁.腹腔镜胆囊切除术联合胆道镜探查术在胆囊结石合并胆总管结石中的应用[J].黑龙江医学,2017,41(7):611-613.
[11]张勇,郭子健,周俊晶,等.腹腔镜下胆道镜联合钬激光碎石并胆总管一期缝合治疗继发性胆总管结石的疗效观察[J].中国现代医药杂志,2016,18(11):58-59.
[12]蓝宇.腹腔镜联合纤维胆道镜治疗胆囊结石合并胆总管结石的临床效果分析[J].南通大学学报:医学版,2016,36(4):324-325.
[2]蔡宇,何彦安.胆囊结石合并胆总管结石患者行腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发危险因素分析[J].肝胆外科杂志,2016,24(3):203-205.
[3]陈凯,苏洪德,巴音达拉.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的安全性[J].中外医学研究,2017,15(28):12-13.
[4]胡学斌,赵云青,刘斌.腹腔镜胆道镜联合钬激光治疗胆总管难取性结石的技术及效果分析[J].中外医学研究,2016,14(16):110-112.
[5]吕运海,张焕常,宋朝阳,等.腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发相关因素的Logistic回归分析[J].重庆医学,2016,45(9):1262-1264.
[6]梁刚,马富平,何盟国.腹腔镜联合胆道镜经胆囊管治疗胆囊结石合并胆总管结石的临床分析[J].临床肝胆病杂志,2017,33(11):2170-2172.
[7]游勤建,袁发秀,宋平.腹腔镜联合胆道镜与传统开腹手术治疗胆囊结石合并胆总管结石的疗效对比[J].河北医学,2016,22(5):721-724.
[8]王鹏,刘会东,阚永丰.全腹腔镜下联合胆道镜胆囊切除、胆总管切开探查取石Ⅰ期缝合的可行性研究[J].中国社区医师,2016,32(14):67.
[9]兰淑.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的护理体会[J].心理医生,2017,23(4):167-168.
[10]杨冠宁.腹腔镜胆囊切除术联合胆道镜探查术在胆囊结石合并胆总管结石中的应用[J].黑龙江医学,2017,41(7):611-613.
[11]张勇,郭子健,周俊晶,等.腹腔镜下胆道镜联合钬激光碎石并胆总管一期缝合治疗继发性胆总管结石的疗效观察[J].中国现代医药杂志,2016,18(11):58-59.
[12]蓝宇.腹腔镜联合纤维胆道镜治疗胆囊结石合并胆总管结石的临床效果分析[J].南通大学学报:医学版,2016,36(4):324-325.