腹腔镜联合胆道镜手术治疗胆总管结石的效果及对患者胃肠功能的影响

Therapeutic effect of laparoscopic combined with choledochoscopic surgery on choledocholithiasis and its influence on gastrointestinal function of patients

目的分析腹腔镜联合胆道镜手术治疗胆总管结石的效果及对患者胃肠功能的影响。方法抽取2015年1月至2021年5月郑州市第三人民医院收治的胆总管结石患者60例,按照随机数字表法分为对照组与研究组,每组30例。对照组采用传统开腹手术治疗,研究组采用腹腔镜联合胆道镜手术治疗。比较两组围术期指标(手术时间、术中出血量、住院时间)、术后胃肠功能恢复情况(排气时间、肠鸣音恢复时间、排便时间)、视觉模拟评分法(VAS)评分及并发症发生率。结果研究组手术时间、住院时间短于对照组,术中出血量少于对照组(P<0.05)。研究组排气时间、肠鸣音恢复时间、排便时间短于对照组(P<0.05)。术后1 d,研究组VAS评分[(4.58±0.33)分]低于对照组[(6.35±0.62)分],差异有统计学意义(P<0.05)。研究组并发症发生率(3.33%,1/30)低于对照组(16.67%,5/30),差异有统计学意义(χ^(2)=4.71,P=0.030)。结论腹腔镜联合胆道镜应用于胆总管结石治疗中效果显著,能明显缓解疼痛症状,缩短手术时间和住院时间,改善患者胃肠功能,降低术后并发症发生率。

Objective To analyze the therapeutic effect of laparoscopic combined with choledochoscopic surgery in the treatment of choledocholithiasis and its influence on gastrointestinal function.Methods A total of 60 patients with choledocholithiasis treated in the Third People’s Hospital of Zhengzhou from January 2015 to May 2021 were selected,and they were divided into control group and study group according to random number table method,with 30 cases in each group.The control group was treated by conventional laparotomy,while the study group was treated by laparoscopic combined with choledochoscopic surgery.Perioperative indexes(operation time,intraoperative blood loss,hospital stay),postoperative gastrointestinal function recovery(exhaust time,bowel sound recovery time,defecation time),visual analogue scale(VAS)score and incidence of complication of the two groups were compared.Results Compared with the control group,the operation time and hospital stay of the study group were shorter,and the intraoperative blood loss of the study group was less(P<0.05).Compared with the control group,the exhaust time,bowel sound recovery time and defecation time of the study group were shorter(P<0.05).The VAS score of the study group(4.58±0.33)was lower than that of the control group(6.35±0.62)1 day after surgery(P<0.05).The incidence of complication of the study group(3.33%,1/30)was lower than that of the control group(16.67%,5/30),and the difference was significant(χ^(2)=4.71,P=0.030).Conclusions Laparoscopic combined with choledochoscopic surgery has a significant effect in the treatment of choledocholithiasis,which can significantly relieve pain symptoms,shorten operation time and hospital stay,improve gastrointestinal function of patients,and reduce the incidence of postoperative complications.