腹腔镜胆总管切开取石T管引流术对肝胆管结石患者疗效及并发症的影响

Influence of Laparoscopic Choledocholithotomy and T-tube Drainage on the Curative Effect and Complications of Patients with Hepatic Bile Duct Stones

目的研究腹腔镜胆总管切开取石T管引流术(laparoscopic choledocholitlaotomy T-tube drainage,LCHTD对肝胆管结石患者疗效及并发症的影响。方法采用随机数表法将2021年1月—2022年12月麻城市人民医院收治的90例肝胆管结石患者分为两组,对照组(45例)行开腹手术治疗,研究组(45例)行LCHTD治疗,比较两组术后恢复情况、生化指标、并发症情况及健康状况评分。结果研究组术后排气时间、胃肠蠕动恢复时间及住院时间分别为(19.02±2.58)h、(1.75±0.36)d、(10.23±1.12)d,对照组分别为(26.47±3.11)h、(2.63±0.52)d、(11.49±1.45)d,差异有统计学意义(t=12.368、9.334、4.613,P<0.001);术后研究组结合胆红素(CB)、非结合胆红素(UCB)及总胆红素(TBIL)水平分别为(4.91±0.95)、(15.87±2.26)、(28.64±3.31)μmol/L,对照组分别为(6.42±1.27)、(18.11±2.65)、(34.28±4.42)μmol/L,差异有统计学意义(t=6.387、4.314、6.852,P<0.001)。研究组并发症发生率低于对照组,且术后健康状况评分高于对照组,差异有统计学意义(P<0.05)。结论LCHTD治疗肝胆管结石并发症较少,可有效加快患者术后恢复,改善其健康状况。

Objective To study the curative effect and complications of laparoscopic choledocholithotomy and T-tube drainage(LCHTD)in patients with hepatolithiasis.Methods A random number table method was used to divide 90 patients with hepatolithiasis in Macheng People′s Hospital from January 2021 to December 2022 into two groups.The control group(45 cases)underwent laparotomy,and the study group(45 cases)underwent LCHTD treatment.The postoperative recovery,biochemical indicators,complications and health status scores were compared between the two groups.Results The postoperative exhaust time,gastrointestinal peristalsis recovery time,and hospitalization time in the study group were(19.02±2.58)hours,(1.75±0.36)days,and(10.23±1.12)days,respectively.The control group was(26.47±3.11)hours,(2.63±0.52)days,and(11.49±1.45)days,and the difference was statistically significant(t=12.368,9.334,4.613,P<0.001);the levels of conjugated bilirubin(CB),unconjugated bilirubin(UCB),and total bilirubin(TBIL)in the postoperative study group were(4.91±0.95),(15.87±2.26),(28.64±3.31)μmmol/L,control group(6.42±1.27),(18.11±2.65),(34.28±4.42)μmol/L,the difference was statistically significant(t=6.387,4.314,6.852,P<0.001).The incidence of complications in the study group was lower than that in the control group,and the postoperative health status score was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion LCHTD has fewer complications in the treatment of hepatolithiasis,which can effectively speed up postoperative recovery and improve the health status of patients.