摘要
目的比较双镜联合保胆取石与腹腔镜胆囊切除术治疗胆结石的临床疗效。方法选取2015-01~2015-06该院收治的胆结石患者136例,按不同手术方式分为内镜微创保胆取石术(EMIC)组和腹腔镜胆囊切除术(LC)组,各68例,EMIC组行腹腔镜联合胆道镜保胆取石术,LC组行腹腔镜胆囊切除术,采用消化病生存质量指数(GLQI)量表评估两组患者手术前后的生活质量,比较两组各项观察指标。结果术前,EMIC组和LC组生理功能状态、主观症状、心理情绪、日常生活状态、社会活动状态及总分基本相同,差异无统计学意义(P>0.05)。术后3个月,EMIC组生理功能状态、主观症状、心理情绪、日常生活状态及总分均显著高于对照组,差异具有统计学意义(P<0.05),EMIC组和LC组社会活动状态基本相同,差异无统计学意义(P>0.05)。EMIC组和LC组临床疗效基本相同,差异无统计学意义(P>0.05),EMIC组术中出血量、住院时间、复发率与LC组比较差异无统计学意义(P>0.05),LC组手术时间、排气时间短于EMIC组,差异具有统计学意义(P<0.05)。结论两种手术方式治疗胆结石均安全有效,腹腔镜联合胆道镜保胆取石术可提高患者生活质量,值得临床选用。
Objective To compare the clinical effects between gallbladder-retention cholelithotomy in combination with two endoscopies and laparoscopic cholecystectomy on treating gallstones.Methods 136 patients with gallstones were selected in our hospital from January 2015 to June 2015 and were randomly divided into EMIC group and LC group,with 68 cases in each group.The EMIC group received gallbladder-retention cholelithotomy in combination with two endoscopies,and the LC group received laparoscopic cholecystectomy.Gastrointestinal Quality of Life Index(GLQI)was used to assess the quality of life and the observation indexes were compared between the two groups.Results There were no significant differences in the scores of the status of clinicalsymptoms,psychological mood,status of daily life and social activity and total scores between the EMIC group and the LC group(P>0.05).The scores of the status of physiological function,clinical symptoms,psychological mood,the status of daily life and total scores in the EMIC group were significantly higher than those in the LC group(P<0.05).There were no significant differences in the social activity status,curative effect,mean bleeding volum,hospital stay and recurrence rate between the EMIC group and the LC group(P>0.05).The operation time and venting time of the LC group was significantly shorter than that of the EMIC group(P<0.05).Conclusion The two operation modes are safe and effective for treatment of gallstones,but gallbladder-retention cholelithotomy in combination with two endoscopies is more beneficial to improving the patients′quality of life.
作者
王汉长
WANG Han-chang(The Third Department of General Surgery,Minsheng Hospital of Shantou Chaonan,Guangdong 515154,China)
出处
《中国临床新医学》
2018年第1期61-64,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
腹腔镜
胆道镜
胆囊结石
疗效
Laparoscopy
Choledochoscope
Gallstones
Curative effect