胆囊结石治疗中腹腔镜联合胆道镜保胆取石术与腹腔镜胆囊切除术的疗效对照研究

Comparative Study on Curative Effect of Cholecystolithiasis in Treatment of Laparoscopy Combined with Choledochoscope Lithotomy and Laparoscopic Cholecystectomy

目的分析胆囊结石采用腹腔镜胆囊切除术、腹腔镜联合胆道镜保胆取石术治疗的临床效果。方法 2014年2月—2017年6月,于该院收治的胆囊结石患者中选取88例,随机分为两组,对照组单独采用腹腔镜胆囊切除术治疗,观察组采用腹腔镜联合胆道镜保胆取石术治疗,对比两组手术指标以及并发症发生情况。结果与对照组(24.56±4.59)h对比,观察组术后通气时间(15.02±2.05)h更短,差异有统计学意义(t=15.625 8,P<0.05);与对照组对比,观察组胆总管结石(0.00%)、胆汁反流性胃炎(2.27%)、胆管损伤(0.00%)、腹泻腹胀(2.27%)等并发症发生率更低,差异有统计学意义(χ~2=5.301 2、4.950 0、5.301 2、6.064 7,P<0.05);观察组患者术后24hNRS评分为(2.02±1.20)分,低于对照组的(3.56±1.68)分,差异有统计学意义(t=12.625 8,P<0.05);观察组术后1年的疾病复发率为0.00%,明显低于对照组的11.36%,差异有统计学意义(χ~2=5.301 2,P<0.05)。结论胆囊结石采用腹腔镜联合胆道镜保胆取石术治疗的临床效果显著,术后并发症发生率低,值得广泛推广。

Objective To analyze the clinical effect of cholecystolithiasis in treatment of laparoscopy combined with choledochoscope lithotomy and laparoscopic cholecystectomy.Methods 88 cases of patients with cholecystolithiasis admitted and treated in our hospital from February 2014 to June 2017 were selected and randomly divided into two groups,the control group were treated with simple laparoscopic cholecystectomy,while the observation group were treated with choledochoscope lithotomy and laparoscopic cholecystectomy,and the occurrence of complications was compared between the two groups.Results The postoperative ventilation time in the observation group was shorter than that in the control group[(15.02±2.05)h vs(24.56±4.59)h],and the difference was obvious(t=15.625 8,P<0.05);and the incidence rates of complications such as choledocholithiasis(0.00%),bile reflux gastritis(2.27%),bile duct injury(0.00%),diarrhea and abdominal distention(2.27%)in the observation group were lower than those in the control group,and the differences were obvious(χ^2=5.301 2,4.950 0,5.301 2,6.064 7,P<0.05),and the postoperative 24 hNRS mark in the observation group was lower than that in the control group,[(2.02±1.20)marks vs(3.56±1.68)marks],and the difference was obvious(t=12.625 8,P<0.05),and the recurrence rate of 1-year disease after surgery in the observation group was obviously lower than that in the control group(0.00%vs 11.36%),and the difference was obvious(χ^2=5.301 2,P<0.05).Conclusion The clinical effect of cholecystolithiasis in treatment of laparoscopy combined with choledochoscope lithotomy and laparoscopic cholecystectomy is obvious,and the incidence rate of postoperative complications is low,and it is worth wide promotion.