腹腔镜胆总管探查术治疗复杂性肝胆管结石疗效探讨

Study on Curative Effect of Laparoscopic Common Bile Duct Exploration in Treatment of Complex Hepatobiliary Stone

目的研究对于复杂性肝胆管结石患者使用腹腔镜胆总管探查术治疗的应用效果。方法方便选取该院于2014年2月—2015年3月间收治的复杂性肝胆管结石80例患者,按照手术方法不同将其划分为对照组40例与干预组40例,对照组患者接受传统开腹胆总管治疗方法 ,干预组患者接受腹腔镜胆总管探查术治疗,比较两组患者手术用时、术中出血量、术后排气时间、住院时间及花费等,比较患者并发症发生率,比较患者生活质量评分。结果对照组患者手术用时(209.24±36.41)min、术中出血量(86.15±16.28)m L、术后首次排气时间(27.05±5.01)h及住院时间(15.28±3.25)d、手术费用(8 949.25±431.23)元,干预组上述指标分别为(160.15±24.60)mm、(56.06±10.14)m L、(18.44±3.23)h、(10.08±2.01)d、(8 217.52±331.67)元,对照组上述用时均较长,干预组手术总费用较低(P<0.05)。对照组患者术后并发症发生率为22.5%,干预组为7.5%,干预组发生率较低(P<0.05)。对照组患者健康状态、症状改善及社会活动、日常生活能力、精神等指标评分均低于干预组(P<0.05)。结论该研究中,对肝胆管结石患者实施腹腔胆总管探查手术治疗取石,术后患者生活质量评分较好,机体恢复情况较为乐观,手术用时较短、且手术总体花费不高,患者术后并发症发生率较低。

objective To re se a rch th e ap p l ic a t io n effect of lapa ro scop ic common b i le d u c t explorat ion in tre a tm en t of com-plex hepatobi l iary stone. Methods 80 c a se s of p a t ien ts with complex h ep a to b ilia ry stone adm it ted an d tre a ted in our h o sp i-tal from February 2014 to March 2015 were convenient selected and divided into two groups with 40 cases in each accord-ing to the operat ion method, the control group were treated with tradi t ional open common bi le duct, while the intervention group were treated with laparoscopic common bile duct explorat ion, and the operat ive time, intraoperat ive bleeding, pos top-erat ive exhaust ion, length of stay and expenses, incidence rate of complicat ions and quality of life score of pat ients were summarized. Results The ope rat iv e time, in trao p e ra tiv e b le ed in g amount, f irs t posto pe ra tiv e ex h au st io n, leng th of stay and operat ive cost were respectively （209.24±36.41）min, （86.15±16.28）mL, （27.05±5.01）h, （15.28±3.25）d and （8 949.25±431.23） yuan in the control group, and （160.15±24.60）mm,（56.06±10.14）mL,（18.44±3.23）h,（10.08±2.01）d,（8 217.52±331.67）yuan in the intervention group, and the operat ive time in the control group was longer, and the total operat ive cost in the interven-tion group was lower （P〈0.05）, and the incidence rate of pos toperative complicat ions in the intervention group was lower than that in the control group （7.5% vs 22.5%） （P〈0.05） , and the healthy state, symptom improvement, social activi ty, daily Con-good, the quality of life score of pos toperative pat ients is good, organism body rehabi l i tat ion is opt imis tic, operat ive time is shorter and the total operat ive cost is not high, and the incidence rate of pos toperative complicat ions of pat ients is lower.