三镜结合免T管引流应用于胆囊结石合并胆总管结石患者中的效果分析

Analysis of the Effect of Triple Lens Combined with T-tube Free Drainage in Patients with Cholecystolithiasis and Choledocholithiasis

目的 分析三镜结合免T管引流应用于胆囊结石合并胆总管结石患者中的应用价值。方法 回顾性选取2021年8月—2023年1月期间麻城市人民医院收治的胆囊结石合并胆总管结石患者86例,根据治疗方式差异将其分为观察组和对照组,各43例。观察组实施三镜结合免T管引流治疗,对照组实施腹腔镜下胆道探查术,对比两组患者引流量、手术相关指标、肝功能、短期并发症发生率、疼痛度以及生活质量。结果 观察组手术时间长于对照组,住院、排气、下床以及抗生素使用时间短于对照组,差异有统计学意义(P<0.05)。术后第1、2、3天,观察组腹腔引流量、胆汁引流量均低于对照组,差异有统计学意义(P<0.05)。观察组短期内并发症发生率为4.65%,低于对照组的23.26%,差异有统计学意义(χ^(2)=6.198,P<0.05)。术后24、48、72 h以及1周,与对照组相比,观察组疼痛度更低,差异有统计学意义(P<0.05)。观察组术后生活质量水平高于对照组,差异有统计学意义(P<0.05)。结论 针对胆囊结石并胆总管结石患者实施三镜结合免T管引流治疗,对患者的创伤更小、术后恢复更快且术后痛苦低,患者在短期内无严重并发症。

Objective To analyze the application value of triple lens combined with T-tube free drainage in patients with cholecystolithiasis and choledocholithiasis.Methods A retrospective analysis was performed on eighty-six patients with cholecystolithiasis combined with choledocholithiasis admitted to Macheng People's Hospital from August 2021 to January 2023,and they were divided into observation group and control group according to the difference in treatment methods,with forty-three cases in each group.The observation group was treated with triple lens combined with T-tube free drainage,and the control group was treated with laparoscopic biliary exploration.The drainage volume,operative related indexes,liver function,short-term complication rate,pain degree and quality of life were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,the hospitalization,exhaust,getting out of bed and antibiotic use time were shorter than that of the control group,and the difference was statistically significant(P<0.05).The abdominal drainage volume and bile drainage volume in the observation group were lower than those in the control group on the 1 d,2 d and 3 d after operation,and the difference was statistically significant(P<0.05).The short-term incidence of complications in the observation group was 4.65%,lower than the control group's 23.26%,and the difference was statistically significant(χ2=6.198,P<0.05).At 24 h,48 h,72 h,and 1 week after surgery,compared with the control group,the observation group had lower pain levels,and the difference was statistically significant(P<0.05).The postoperative quality of life level of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Con⁃clusion For patients with cholecystolithiasis and choledocholithiasis,triple lens combined with T-tube free drainage has less trauma,faster postoperative recovery and lower postoperative pain,and patients have no serious complications in the short term.