微创保胆取石术治疗胆囊结石疗效观察

Observation on Clinical Efficacy of Gallbladder-Preserving Minimally Invasive Cholecystolithotomy in Treating Gallstone

目的对比分析微创保胆取石术与腹腔镜胆囊切除术治疗胆囊结石的临床疗效。方法按照随机数表法将2015年10月—2017年1月唐河县人民医院普外科收治的90例胆囊结石患者随机分为保胆组(45例)与对照组(45例),其中保胆组患者采用微创保胆取石术予以治疗,对照组患者采用腹腔镜胆囊切除术予以治疗,对比观察两组患者的胆囊结石一次取净率、手术时间、术中失血量、术后首次排气时间、住院时间、并发症发生率及生活质量等。结果两组患者胆囊结石一次取净率对比采用卡方检验,χ~2=2.045,P>0.05,差异无统计学意义;手术时间、术后首次排气时间、住院时间、生活质量总分对比方差不齐,采用t'检验,t'值分别为8.875、19.740、5.262、227.828,P均<0.01,差异具有统计学意义;术中失血量对比采用t检验,t=39.331,P<0.01,差异具有统计学意义;并发症发生率对比采用卡方检验,χ~2=4.406,P<0.05,差异具有统计学意义。结论微创保胆取石术治疗胆囊结石可有效缩短手术时间及住院时间,减少术中失血量,降低反流性胃炎、胆管损伤等并发症的发生率,提高患者生活质量,且手术操作简便,安全可靠,值得临床推广应用。

Objective To compare and observe the clinical efficacy of gallbladder-preserving minimally-invasive cholecystolithotomy in treating gallstone. Methods Ninety patients with gallstone admitted to General Surgery Department,Tanghe People＇s Hospital between October 2015 and January 2017 were divided,according to random number table,into gallbladder-preserving cholecystolithotomy group（ hereinafter referred to as gallbladder group）（45 cases） and control group（45 cases）. The former group was treated with gallbladder-preserving cholecystolithotomy while the latter was treated with laparoscopic cholecystectomy. Gallstone one-time removal rate,operation time,intraoperative blood loss,first intestinal gas exhaust time after operation,hospitalization duration,complication occurrence rate and life quality were compared and observed. Results Chi-square test was used for the comparison of one-time gallstone removal rate for patients of the two groups and the results showed no statistically significant difference（ χ~2= 2. 045,P〈0. 05）; due to unequal variances of operation time,postoperative first intestinal gas exhaust time,hospitalization duration,and life quality scores,t＇ test were used for between-group comparison and the results showed statistically significant difference（ t＇ = 8. 875,19. 740,5. 262 and 227. 828 respectively,all P〈0. 01）; t test was used for the comparison of intraoperative blood loss of patients in the two groups and the results showed statistically significant difference（ t = 39. 331,P〈0. 01）; chi-square test was used for the comparison of complication occurrence rate of patients in the two groups and the results showed statistically significant difference（ χ~2= 4. 406,P〈0. 05）. Conclusion Gallbladder-preserving minimally-invasive cholecystolithotomy can effectively shorten operation time and hospitalization duration,reduce intraoperative blood loss and the occurrence rate of complications including reflux gastritis,bile duct injury,etc.,and improve patient＇s life quality,in addition to its reliability and simple procedure,deserving to be promoted in clinical practice.