腹腔镜下小切口胆道探查术对复发性肝外胆管结石患者围术期临床指标及并发症的影响

Effect of Laparoscopic Small Incision Biliary Exploration on Perioperative Clinical Indexes and Complications inPatients with Recurrent Extrahepatic Bile Duct Stones

目的:研究腹腔镜下小切口胆道探查术对复发性肝外胆管结石患者围术期临床指标及并发症的影响。方法:选取2018年2月—2023年2月菏泽市鄄城县人民医院收治的复发性肝外胆管结石患者80例作为研究对象,根据随机数字表法分为对照组和观察组,各40例。对照组施以开腹胆道探查术,观察组施以腹腔镜下小切口胆道探查术。比较两组围术期临床指标、并发症发生率、疼痛程度及生活质量评分。结果:观察组腹腔粘连分离时间、术后首次肛门排气时间、术后住院时间均短于对照组,术中失血量少于对照组,术后镇痛率低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P=0.0026);治疗后,两组视觉模拟评分法评分均降低,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组社会功能、角色功能、情绪功能、躯体功能、认知功能及总体健康状况评分均升高,观察组高于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜下小切口胆道探查术能够改善复发性肝外胆结石患者的围术期指标,降低并发症发生率、术后镇痛率,缓解疼痛程度,改善生活质量。

Objective:To investigate the effects of laparoscopic small incision biliary exploration on perioperative clinical indexes and complications in patients with recurrent extrahepatic bile duct stones.Methods:Eighty patients with recurrent extrahepatic extrahepatic bile duct stones treated in Heze Juancheng County People's Hospital from February 2018 to February 2023 were se-lected as the research objects.They were divided into control group and observation group according to random number table method,with forty cases in each group.The control group underwent laparotomy and the observation group underwent laparosco-py with small incision.Perioperative clinical indexes,complication rate,pain degree and quality of life were compared between the two groups.Results:The time of abdominal adhesion separation,the time of the first anus after surgery,and the time of post-operative hospitalization in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the postoperative analgesia rate was lower than that in the control group,with statistical significance(P<0.05);The complication rate of the observation group was lower than that of the control group,the difference was statistically significant(P=0.0026);After treatment,the score of visual analogue score was decreased in both groups,and the ob-servation group was lower than the control group,the difference was statistically significant(P<0.05);After treatment,the scores of social function,role function,emotional function,physical function,cognitive function and general health status of both groups were increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic biliary exploration with small incision can improve perioperative indexes of patients with recurrent extra-hepatic bile duct stones,reduce complication rate,postoperative analgesia rate,relieve pain degree,and improve quality of life.