自制推结器在腹腔镜胆囊切除术中的应用
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摘要
目的观察自制推结器在腹腔镜胆囊切除术(LC)中的应用效果及安全性。方法回顾性分析我院应用自制推结器行LC术的685例患者(观察组)及行统LC术的618例患者(对照组)。记录两组患者所用手术时间、中转开腹手术、术中胆管损伤及术后并发症发生情况。结果观察组平均手术时间(26.84±13.07)min低于对照组(38.05±18.33)min,差异显著(t=12.801,P<0.01);观察组术中胆管损伤率(0.15%)和中转开腹手术率(0.29%)均低于对照组(0.32%、0.81%),但差异不具显著性(t=0.008、0.802,P>0.05);两组患者术后均无出血现象,观察组无胆漏发生,且切口感染率(0.44%)和总体并发症发生率(0.44%)均低于对照组(0.65%、0.81%),但差异不具显著性(χ2=0.018、0.251,P>0.05)。结论 LC术中应用自制推结器是一种简单、实用、安全、经济且容易掌握的手术方法,能有效减少患者术中副损伤、术后并发症,缩短手术操作时间,有益于LC术工作的开展和推广。
Objective To observe the knot pusher in laparoscopic cholecystectomy( LC) in the clinical effect. Methods Retrospective analysis of our hospital 685 cases of application of self-made knot device for LC patients( observation group),and for the LC operation in 618 patients( control group). The operation time of the two groups of patients were recorded,the conversion to open surgery,intraoperative bile duct injury and postoperative complications. Results The average operation time of the observation group was significantly lower than that of the control group( P < 0. 01). The bile duct injury rate and the rate of conversion to laparotomy were lower than the control group,but the difference was not significant( P > 0. 05). The two groups had no bile leakage,and the incision infection rate and overall complication rate were lower than the control group,but the difference was not significant( P > 0. 05).Conclusion Application of self-made knot pusher for LC operation is a simple,practical,safe,economic and easy operation method can effectively reduce the side injury,complications of patients,shorten the operation time,the popularization and development of LC is beneficial to the operation work.
Objective To observe the knot pusher in laparoscopic cholecystectomy( LC) in the clinical effect. Methods Retrospective analysis of our hospital 685 cases of application of self-made knot device for LC patients( observation group),and for the LC operation in 618 patients( control group). The operation time of the two groups of patients were recorded,the conversion to open surgery,intraoperative bile duct injury and postoperative complications. Results The average operation time of the observation group was significantly lower than that of the control group( P < 0. 01). The bile duct injury rate and the rate of conversion to laparotomy were lower than the control group,but the difference was not significant( P > 0. 05). The two groups had no bile leakage,and the incision infection rate and overall complication rate were lower than the control group,but the difference was not significant( P > 0. 05).Conclusion Application of self-made knot pusher for LC operation is a simple,practical,safe,economic and easy operation method can effectively reduce the side injury,complications of patients,shorten the operation time,the popularization and development of LC is beneficial to the operation work.
引文
1张玉娟,刘蓉,张晓静,等.自制橡胶袋在腹腔镜胆囊切除术中的应用.护士进修杂志,2012,27(14):1334-1335.
2 田金豹,冉启华,陈宏尊,等.自制打结器3孔法腹腔镜胆囊切除术208例.第三军医大学学报,2005,27(5):439-439,442.
3 张毅杰,何志新,周卫忠,等.自制套扎线无钛夹腹腔镜胆囊切除术的临床研究.中国内镜杂志,2010,16(2):121-123.
4 祁元琴,郭吉伦.自制保护袋在腹腔镜胆囊切除术中的应用.护理研究,2010,24(26):2408.
5 黄代恩,陆昌友.自制标本取出袋在腹腔镜胆囊切除术中的临床应用.中国医药指南,2015,(6):191-192.
6 Khan OA1,Balaji S,Branagan G,et al.Randomized clinical trial of routine on-table cholangiography during laparoscopic Cholecystectomy.Br J Surg.2011,98(3):362-367.
7 张志华,郑新玲.自制取物袋在腹腔镜胆囊切除手术中的应用.国际护理学杂志,2014,33(1):139.
8 胡明秋,宋希江,姜成文,等.三孔免钛夹腹腔镜胆囊切除术的临床研究.天津医科大学学报,2010,16(1):84-86.
9 李晓龙,吴硕东,韩金岩,等.单孔法与三孔腹腔镜胆囊切除术的临床对比研究.中国现代普通外科进展,2012,15(12):990-991,996.
10 顾叶春,郑志强.三孔线扎法腹腔镜胆囊和阑尾联合切除术临床研究.实用医学杂志,2010,26(9):1553-1556.
2 田金豹,冉启华,陈宏尊,等.自制打结器3孔法腹腔镜胆囊切除术208例.第三军医大学学报,2005,27(5):439-439,442.
3 张毅杰,何志新,周卫忠,等.自制套扎线无钛夹腹腔镜胆囊切除术的临床研究.中国内镜杂志,2010,16(2):121-123.
4 祁元琴,郭吉伦.自制保护袋在腹腔镜胆囊切除术中的应用.护理研究,2010,24(26):2408.
5 黄代恩,陆昌友.自制标本取出袋在腹腔镜胆囊切除术中的临床应用.中国医药指南,2015,(6):191-192.
6 Khan OA1,Balaji S,Branagan G,et al.Randomized clinical trial of routine on-table cholangiography during laparoscopic Cholecystectomy.Br J Surg.2011,98(3):362-367.
7 张志华,郑新玲.自制取物袋在腹腔镜胆囊切除手术中的应用.国际护理学杂志,2014,33(1):139.
8 胡明秋,宋希江,姜成文,等.三孔免钛夹腹腔镜胆囊切除术的临床研究.天津医科大学学报,2010,16(1):84-86.
9 李晓龙,吴硕东,韩金岩,等.单孔法与三孔腹腔镜胆囊切除术的临床对比研究.中国现代普通外科进展,2012,15(12):990-991,996.
10 顾叶春,郑志强.三孔线扎法腹腔镜胆囊和阑尾联合切除术临床研究.实用医学杂志,2010,26(9):1553-1556.