微创保胆取石术治疗胆结石的近期疗效及对患者生活质量的影响

Short-term efficacy of minimally invasive gallbladder-preserving cholecystolithotomy and its effect on quality of life in the patients

目的探讨分析微创保胆取石术治疗胆结石的疗效及对患者生活质量的影响。方法选择我院收治的158例胆囊结石患者,按照患者手术方式将其分为微创保胆取石术组(EMIC组)71例、腹腔镜胆囊切除术组(LC组)87例,比较两组患者手术效果、治疗后生活质量以及并发症发生情况。结果 EMIC组患者术中出血量、手术时间、术后肛门首次排气时间以及住院时间均显著低于LC组(P<0.05);治疗后EMIC组患者生理功能状态、主观症状、心理情绪状态、日常生活及社会活动状态以及生活质量总分均显著高于LC组(P<0.05);EMIC组患者术后并发症发生率为7.04%(5/71),LC组患者术后并发症发生率为18.39%(16/87),两组比较差异具有统计学意义(P<0.05)。结论微创保胆取石术对患者创伤小、安全性高,患者术后恢复快,保留了机体胆囊的生理功能,有助于患者术后生活质量的提高,且术后并发症发生率低,值得临床推广运用。

Objective To investigate the efficacy of minimally invasive gallbladder-preserving cholecystolithotomy in the treatment of gallstone and determine its effect on the quality of life of patients. Methods A total of 158 patients with gallbladder stones who admitted in our department from January 2014 to December 2015 were recruited in this study and assigned into endoscopic minimal invasive cholecytolithotomy with gallbladder preserving （ EMIC group, n = 71 ） and laparoscopic cholecystectomy （ LC group, n = 87） according to their surgical approaches. The surgical efficacy, quality of life after treatment and complication oecurrences were compared between the 2 groups. Results The amount of bleeding, operation time, first exhaust time and length of hospital stay were significantly lower in the patients of EMIC group than those of group LC （P 〈 0. 05 ）. After the treatment, the EMIC group had obviously higher scores in physiological functions, subjective symptoms, psychological state, daily life and social activities when compared with the LC group （P 〈0.05）. The incidence of postoperative complications was 7.04% （5/71） in the EMIC group, and 18.39% （16/87） in the LC group, with the statistically difference between the 2 groups （P 〈 0.05）. Conclusion EMIC with gallbladder preserving is of many advantages, including small trauma and high safety for the patients with gallstone, quick recovery and reservation of the physiological functions of the gallbladder, improvement of quality of life after surgery, and lower postoperative complication occurrence. So it is worth of clinical application.