分析腹腔镜结合内镜治疗肝胆结石性疾病的临床效果

Analysis of Clinical Effects of Laparoscopic Combined with Endoscopy in the Treatment of Hepatolithiasis

目的探讨肝胆结石性疾病临床治疗中联合应用腹腔镜、内镜的效果。方法方便选择该院于2018年1月—2019年1月期间收治的肝胆结石性疾病患者90例,以患者就诊日期奇偶性以及抓阄法划分为研究组与参照组,每组45例患者,参照组患者接受传统开腹手术治疗,研究组患者接受腹腔镜联合内镜治疗,对比两组患者的手术时间、术中出血量、肠鸣音恢复时间、肛门排气时间、住院时间以及切口感染率、镇痛药使用率。结果研究组患者的手术时间(91.15±15.43)min与参照组患者的(92.25±16.73)min较为接近,即组间差异无统计学意义(t=0.324,P>0.05);但研究组患者的术中出血量(29.39±15.11)mL、肠鸣音恢复时间(12.10±2.11)h、肛门排气时间(26.02±12.08)h以及住院时间(8.02±1.41)d,与参照组患者的术中出血量(52.23±18.56)mL、肠鸣音恢复时间(25.30±3.31)h、肛门排气时间(50.12±7.20)h以及住院时间(15.22±1.41)d进行对比,组间差异有统计学意义(t=6.402、22.558、11.496、24.222,P<0.05);研究组患者的切口感染率为0.00%,镇痛药使用率为8.89%,均低于参照组患者,数据组间差异有统计学意义(χ^2=5.294、5.874,P<0.05)。结论对肝胆结石性疾病患者行腹腔镜联合内镜治疗,创伤性较小,可以减少患者术中出血量,降低患者并发症发生率,有利于患者实现早期康复。

Objective To investigate the effect of combined laparoscopy and endoscopy in the clinical treatment of hepatolithiasis.Methods A total of 90 patients with hepatolithiasis admitted to our hospital from January 2018 to January 2019 were conveniently selected.The patients were divided into study group and reference group by the date of the patient's visit and the method of grasping the sputum.Each group consisted of 45 patients.Patients in the reference group underwent conventional open surgery.Patients in the study group underwent laparoscopic and endoscopic treatment.The operation time,intraoperative blood loss,recovery time of bowel sounds,anal exhaust time,hospital stay,and wound infection rate,analgesic use rate were compared between the two groups.Results The operation time of the study group(91.15±15.43)min was close to that of the reference group(92.25±16.73)min,that is,the statistical significance of the difference between the groups was not established(t=0.324,P>0.05);however,the study group patients Intraoperative blood loss(29.39±15.11)mL,bowel sound recovery time(12.10±2.11)h,anal exhaust time(26.02±12.08)h,and hospitalization time(8.02±1.41)d,and the reference group of patients of the amount of hemorrhage(52.23±18.56)mL,recovery time of bowel sounds(25.30±3.31)h,anal exhaust time(50.12±7.20)h,and hospitalization time(15.22±1.41)d were compared.The difference between groups was statistically significant(t=6.402,22.558,11.496,24.222,P<0.05);the incision infection rate was 0.00%in the study group,and the analgesic use rate was 8.89%,which was lower than that in the reference group,statistically significant(χ^2=5.294,5.874,P<0.05).Conclusion Laparoscopic and endoscopic treatment for patients with hepatolithiasis is less invasive,which can reduce the amount of intraoperative blood loss and reduce the incidence of complications,which is conducive to early rehabilitation.