小切口胆总管探查术安全性及临床效果评价

Safety and clinical results of mini-incision exploration of common bile duct

目的系统评价小切口胆总管探查术的安全性及临床效果。方法550例胆管结石患者分别施行小切口胆总管探查术(MCE组,300例)和传统切口胆总管探查术(OCE组,250例),就术中意外伤、术后并发症、结石残留、术后一般情况和护理资料等进行对比分析,并总结护理经验。结果术后下床活动、住院、术后肛门排气以及禁食时间,MCE组均少于OCE组(P<0.05);术后血迹管引流量,MCE组亦少于OCE组(P<0.05),但两组的T管引流量、术中意外损伤发生率、术后结石残留率、结石复发率差异均无统计学意义(P>0.05);MCE组术后发生并发症17例(6.80%),传统组为26例(10.40%),两组比较差异有统计学意义(P<0.05)。结论MCE是一种安全、有效、预后良好、恢复时间快的手术方式。密切观察生命体征及引流,及早发现并发症,及早处理,加强术后护理是关键。

Objective To evaluate the safety,feasibility and clinical result of mini-incision exploration of common bile duct.Methods Min-incision exploration of common bile duct（MCE）was carried out in 300 patients with gallstones and open-incision exploration of common bile（OCE）was carried out in 250 of them.Comparative analysis was carried out to study accidental injury,postoperative complication,residual stone,stone recurrence,curative effect and the nursing data.Results Drainage flow of blood tubes,time of recovery,time of intestinal peristalsis,length of stay and time of fasting in MCE group were less than those of OCE group.There was no significant difference between the two groups in accidental injury,residual stone and stone recurrence.Postoperative complications occurred in 17 cases （6.80%） of MCE group and 26 cases （10.40%） of OCE group.There was significant difference between the two groups.Conclusion MCE is a safe and feasible method with good prognosis and fast recovery time.Close observation of vital signs and drainage,early detection of complications,early treatment and careful post-operative nursing are suggested.Safety and clinical results of mini-incision exploration of common bile duct