微创手术治疗肝胆管结石的临床效果观察

Clinical efficacy observation of minimally invasive surgery in the treatment of hepatolithiasis

目的：探讨微创手术治疗肝胆管结石的效果，为临床应用提供参考。方法选取2009年3月～2014年5月入住本院的肝胆管结石患者42例，随机分成对照组和观察组，每组21例。对照组给予常规手术治疗，观察组给予微创手术治疗。对两组患者手术时间、术中出血量、胃肠道蠕动恢复时间、下床活动时间、住院时间、临床疗效及并发症发生率进行分析比较。结果观察组手术时间、胃肠道蠕动恢复时间、下床活动时间及住院时间均短于对照组，术中出血量少于对照组，差异均有统计学意义（P〈0.05）。观察组的残石率、复发率低于对照组，差异均有统计学意义（P〈0.05）。观察组并发症发生率为4.8%，低于对照组的28.6%，差异有统计学意义（P〈0.05）。结论微创手术方法可以有效治疗肝胆管结石，手术时间、住院时间短于常规手术，术中出血量少于常规手术，并发症发生率低于常规手术，值得临床推广应用。

Objective To investigate clinical efficacy of minimally invasive surgery in the treatment of hepatolithiasis and provide clinical reference for application. Methods 42 patients with hepatolithiasis in our hospital from March 2009 to May 2014 were selected and randomly divided into control group and observation group,each group of 21 cases. The conventional surgical treatment was used in control group,minimally invasive surgery was applied in observation group.The operative time,blood loss,gastrointestinal motility recovery time,ambulation time,length of stay,clinical efficacy and incidence rate of complication in two groups were analyzed and compared. Results The operative time,gastroin-testinal motility recovery time,ambulation and hospital stay in observation group was shorter than that in control group respectively,blood loss in observation group was less than that in control group,with statistical difference （P〈0.05）.The residual stone rate,recurrence rate in observation group was lower than that in control group respectively,with statistical difference （P〈0.05）.Incidence rate of complication in observation group was 4.8%,lower than that in control group （28.6%）,with statistical difference （P〈0.05）. Conclusion Minimally invasive surgery can effectively treat hepatolithiasis, the operative time,hospital stay in patients with minimally invasive surgery is shorter than that in patients with conven-tional surgery respectively,blood loss is less than that in patients with conventional surgery,incidence rate of complica-tion is lower than that in patients with conventional surgery,which is worthy of promotion and application in clinic.