微型腹腔镜行胆囊切除术的临床应用价值

Clinical application of miniature laparoscopic instrument cholecystectomy

目的:探讨微型腹腔镜行胆囊切除(MLC)术的难度及对患者的影响。方法:随机把60例胆囊结石、慢性胆囊炎、胆囊息肉患者分为腹腔镜胆囊切除术(LC)组和微型腹腔镜胆囊切除术(MLC)组各30例。对比其手术时间、术后疼痛程度及术后住院天数。结果:MLC组手术时间平均75±23min,术后平均住院3.5±1.6d,用视觉模拟评分法测定疼痛程度,术后8h和24h分别为8.8±5.6分和4.0±3.0分。LC组手术时间平均70±15min,术后平均住院4.6±2.5d。术后8h和24h疼痛程度分别为30.5±10.7和11.5±6.6。结论:MLC的切口疼痛程度显著低于LC(P<0.05),更有效地减少了患者痛苦,体现了微创优势,腹壁外观改善。MLC难度不比LC大。

Objective: To explore the difficulty and the influence on patients in miniature laparoscopic instrument cholecystectomy(MLC) .Methods:60 cases with cholecystolithiasis,chronic cholecystitus and gallbladder polyp were randomly and equally divided into laparoscopic cholecystectomy(LC)group and miniature laparoscopic instrument cholecys-tectomy(MLC)group.The operative time, the postoperative ache degree and the postoperative hospitalization between the two groups were compared.Results:The average operative time was 75±23min,the average postoperative hospitalization was 3.5±1.6d, the ache degree at 8h and 24h after the operations respectively was 8.8±5.6 and 4.0±3.0 in MLC group.The average surgery time was 70±15min,the average postoperative hospitalization was 4.6±2.5d,the ache degree at 8h and 24h after the operations respectively was 30.5±10.7 and 11.5±6.6 in LC group. Conclusions: MLC has lower postoperative ache degree and minor scar than LC does(P<0.05) ,and is not more difficult than LC.