复杂腹腔镜胆囊切除术应用剪刀剥离安全性分析

Analysis on Safety of Scissors Peeling in Complex Laparoscopic Cholecystectomy

目的分析复杂腹腔镜胆囊切除术应用剪刀剥离的安全性。方法选取2014年5月至2015年5月凉山彝族自治州中西医结合医院收治的复杂胆囊患者108例,按照随机数字表法分为观察组和对照组,各54例。观察组患者予以复杂腹腔镜剪刀剥离胆囊切除术,对照组患者予以复杂腹腔镜常规剥离胆囊切除术,观察比较两组患者手术情况、治疗有效率、并发症发生情况。结果观察组患者的手术时间短于对照组[(45±5)min比(58±6)min],术中出血量少于对照组[(67±4)mL比(76±5)mL],抗生素使用时间、肛门排气时间、住院时间显著短于对照组[(1.52±0.27)d比(2.54±0.32)d,(1.09±0.15)d比(1.67±0.23)d,(3.84±0.51)d比(4.95±0.58)d],差异有统计学意义(P<0.01);观察组的总有效率高于对照组[96.29%(52/54)比85.18%(46/54),P<0.05];总并发症发生率低于对照组[2.31%(5/54)比48.15%(26/54),P<0.05]。结论对于复杂胆囊患者,运用复杂腹腔镜剪刀剥离胆囊切除术可行性高,对肝脏的功能没有明显的伤害,同时可以降低并发症发生率,安全性较高,能够帮助患者尽早的康复。

Objective To analyze the safety of scissors peeling in complex laparescopic cholecystectomy. Methods Total of 108 cases of complex gallbladder in Traditional Chinese and Western Medicine Combined Hospital of Liangshan Prefecture from May 2014 to May 2015 were included in the study,accord- ing to a random number table they were divided into an observation group and a control group,54 cases in each group. The observation group received scissors peeling in complex laparescopic cholecystectomy, while the control group received routine leeling in the complex laparoscopic cholecystectomy. The surgery condition,treatment efficiency, complications of the two groups were observed and compared. Results The obser- vation group＇s operation time was shorter than the control group [ （45 ± 5 ） rain vs （ 58 ± 6 ） rain ], blood loss was less than the control group [ （67 ± 4 ） mL vs （76 ± 5 ） mL ], antibiotic use, flatus and antibiotics time were shorter than the control group [ （ 1.52 ± 0. 27 ） d vs （2.54 ± 0. 32 ） d, （ 1.09 ± 0. 15 ） d vs （ 1.67 ± 0.23） d, （3.84 ±0. 51 ） d vs （4. 95 ±0. 58） d] ,the differences were statistically significant （P 〈0. 01 ） ; the treatment total efficiency rate of the observation group was higher than the control group [ 96. 29% （52/ 54） vs 85. 18% （46/54） ,P 〈0. 05 ] ;total comphcations of the observation greul± was lower than the control group[2.31% （5/54） vs 48. 15% （26/54） ,P 〈0. 05 ]. Conclusion For patients with complicated gallbladder,the feasibility of scissors peeling in complex laparoscopic cholecystectomy is high, with no obvious damage to liver function, and may reduce the risk of complications, with high safety, and is expected to be able to achieve faster recovery.