腹腔镜下胆总管切开取石术治疗胆总管结石患者的临床研究

Clinical Study of Laparoscopic Common Bile Duct Incision for Treatment of Common Bile Duct Stones

目的 分析胆总管结石患者接受腹腔镜下胆总管切开取石术治疗的效果。方法 方便选择2014年1月-2019年2月该院收治胆总管结石患者66例为研究对象,参照计算机抽选结果分为观察组与对照组,对照组患者均接受传统开腹手术治疗,观察组患者均接受腹腔镜联合胆总管切开取石术治疗,比较两组患者临床疗效,统计各组患者手术相关指标差异,计算术后并发症发生率。结果 观察组患者临床总疗效96.97%明显优于对照组(χ^2=6.30,P<0.05)。另外观察组患者切口长度(3.31±0.45)cm明显短于对照组,术中出血量(83.13±3.14)m L较对照组相比更少,手术用时(72.15±1.34)min、患者预后肛门排气时间(8.36±0.35)h、排便时间(16.37±0.41)h、下床活动时间(23.39±1.01)h、住院总时间(6.11±0.42)d均明显短于对照组(t=18.23、21.24、46.46、29.25、23.13、31.23、9.48,P<0.05),观察组患者术后出现并发症的概率较对照组相比更低。结论 胆总管结石患者接受腹腔镜联合胆总管切开取石术治疗效果更佳,可极大程度缩短手术用时及患者恢复时长,患者术后并发生更少,安全性更高,值得推广。

Objective To analyze the effect of laparoscopic common bile duct incision and stone removal in patients with common bile duct stones.Methods 66 patients with common bile duct stones in the hospital from January 2014 to September 2019 were convenient selected as subjects.The results of computer sampling were divided into observation group and control group.The control group were treated with traditional open surgery.All patients in the observation group underwent laparoscopic combined with common bile duct incision and stone removal.The clinical efficacy of the two groups were compared.The differences of surgical related indexes between the groups were counted,and the incidence of postoperative complications was calculated.Results The total clinical efficacy of the observation group was 96.97%,which was significantly better than the control group(χ^2=6.30,P<0.05).In addition,the incision length(3.31±0.45)cm of the observation group was significantly shorter than that of the control group,and the intraoperative blood loss(83.13±3.14)mL was less than that of the control group.The time of surgery(72.15±1.34)min,the patient prognosis anal exhaust time(8.36±0.35)h,defecation time(16.37±0.41)h,time to get out of bed(23.39±1.01)h,total hospitalization time(6.11±0.42)d were significantly shorter than the control group(t=18.23,21.24,46.46,29.25,23.13,31.23,9.48,P<0.05),the probability of postoperative complications in the observation group was lower than that of the control group.Conclusion Patients with common bile duct stones undergoing laparoscopic combined with common bile duct incision and stone removal are better,which can greatly shorten the time of surgery and the recovery time of patients.The patients have fewer postoperative problems and have higher safety.It is worth promoting.