腹腔镜下取石术与开腹手术治疗胆总管结石患者的临床效果比较研究

Comparative Study of Laparoscopic Lithotripsy and Open Surgery in the Treatment of Choledocholithiasis

目的:比较胆总管结石患者采取腹腔镜下取石术与开腹手术的临床效果。方法:选取于2011年1月-2016年9月本院收治的胆总管结石患者125例,采用随机数字表法分为两组,对照组62例患者采取传统开腹胆总管切开取石术,研究组63例患者采取腹腔镜下取石术。比较分析两组患者术中出血量、手术时间、切口长度、术后排气时间和住院时间,以及结石清除率、并发症发生率和治疗总有效率。结果:研究组患者的术中出血量(84.36±12.51)m L、手术时间(76.39±3.14)min、切口长度(3.43±0.27)cm、术后排气时间(9.12±1.65)h及住院时间(7.28±1.64)d均优于对照组,差异均有统计学意义(P<0.05);且研究患者的结石清除率为95.24%、治疗总有效率为98.41%均高于对照组的82.26%、88.71%,并发症的发生率4.76%低于对照组的17.74%,差异均有统计学意义(P<0.05)。结论:腹腔镜下取石术应用于胆总管结石患者,不仅能够减少术中出血量、缩短手术和住院时间,同时具有结石清除率高和并发症低的特点,是一种创伤轻微、安全有效的手术治疗方式。

Objective： To compare the clinical effect of laparoscopic lithotripsy and open surgery in patients with eholedocholithiasis.Method： From January 2011 to September 2016, 125 patients with choledocholithiasis treated in our hospital were divided into two groups according to the random number table method, 62 patients in control group were taken open surgery, 63 patients in study group were taken laparoscopic lithotripsy.The intraoperative blood loss, operation time, incision length, postoperative exhaust time and hospitalization time, stone clearance rate, complication occurrence rate and total effective rate of two groups were compared and analyzed.Result： The study group＇s intraoperative blood loss was （ 84.36 ±12.51 ） mL, operation time was （ 76,39±3.14 ） min, incision length was （ 3.43±0.27 ） cm, postoperative exhaust time was （ 9.12±1.65 ） h and hospitalization time was （ 7.28±1.64 ） days, were all better than those of the control group, the differences were statistically significant （ P〈0.05 ） .The study group＇s stone clearance rate was 95.24%, the total effective rate was 98.41%, both were higher than those of the control group （ 82.26%, 88.71% ）, the complication occurrence rate of study group was 4.76%, lower than that of the control group （ 17.74% ）, the differences were statistically significant （ P〈0.05 ） .Conclusion： Laparoseopie lithotripsy for patients with common bile duct stones, can not only reduce the intraoperative bleeding, shorten the operation and hospitalization time, but also has high stone clearance rate and low complication occurrence rate, which is a mini-invasive, safe and effective operation method.