常规器械经脐单孔腹腔镜胆囊切除术的临床应用价值

Clinical application of single port transumbilical laparoscopic cholecystectomy with conventional instruments

目的:探讨常规器械经脐单孔腹腔镜胆囊切除术的临床应用。方法:选取70例行腹腔镜胆囊切除术的患者为研究对象,依据手术方式不同分为对照组和观察组,每组各35例。对照组行常规腹腔镜胆囊切除术;观察组行常规器械经脐单孔腹腔镜胆囊切除术;比较两组患者两组患者治疗效果、炎性因子水平及并发症发生率。结果:两组患者术中出血量及术后住院时间比较,差异无统计学意义(P>0.05)。观察组患者手术时间长于对照组(P<0.05);平均首次下床时间、总切口长度及治疗费用小于对照组(P<0.05);术后1、2 d静息及活动时疼痛评分小于对照组患者(P<0.05)。观察组患者术后COR、ACTH、、Hs-CRP、IL-6水平低于对照组(P<0.05);满意度高于对照组(P<0.05)。两组患者Ι期愈合率及术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:常规器械行经脐单孔腹腔镜胆囊切除术较传统腹腔镜胆囊切除术治疗效果好,疼痛及炎症反应轻,值得临床推广。

Objective:To analyze the clinical application of single-port transumbilical laparoscopic cholecystectomy with conventional instruments.Methods:A total of 70 patients undergoing laparoscopic cholecystectomy were selected as the observation subjects.According to different treatment methods,the patients undergoing conventional laparoscopic cholecystectomy were included in the control group(n=35),and the patients undergoing conventional single-port laparoscopic cholecystectomy with umbilical instruments were included in the observation group(n=35).The treatment effect,inflammatory factor level and complication rate of the two groups were compared.Results:There was no significant difference in intraoperative blood loss and hospitalization time between the two groups(P>0.05).The operation time in the observation group was longer than that in the control group(P<0.05),average first time out of bed,total incision length and treatment cost were less than those in the control group(P<0.05).The pain scores of 1 d and 2 d after operation in the observation group were smaller than those in the control group.After operation,the levels of COR,ACTH,Hs-CRP and IL-6 in the observation group were lower than those in the control group(P<0.05),the satisfaction in the observation group was higher than that in the control group(P<0.05).There was no significant difference in theΙprimary healing rate and postoperative complications(P>0.05).Conclusion:Compared with traditional laparoscopic cholecystectomy,single port transumbilical laparoscopic cholecystectomy has better therapeutic effect,less pain and inflammatory reaction,which is worthy of clinical promotion.