腹腔镜手术应用于胆结石及胆管结石临床治疗中的效果和安全性

Efficacy and Safety of Laparoscopic Surgery in the Clinical Treatment of Gallstones and Cholangiolithiasis

目的:探讨腹腔镜手术应用于胆结石及胆管结石临床治疗中的效果和安全性。方法:选取2022年5月—2023年5月遵义市播州区人民医院收治的84例胆结石及胆管结石患者,根据随机数表法分为两组,各42例。对照组予以开腹手术治疗,观察组予以腹腔镜手术治疗。比较两组手术相关指标、疼痛情况、白细胞计数、C反应蛋白、生活质量及并发症发生率。结果:观察组手术出血量少于对照组,手术时间、术后肛门排气时间、腹痛消失时间及住院时间短于对照组,差异有统计学意义(P<0.05)。术后1 d、3 d、5 d,观察组视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。术后1 d、3 d,观察组白细胞及C反应蛋白均低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。术后2周、4周、6周、8周,观察组胃肠道综合生活质量指数(GIQLI)评分均高于对照组,差异有统计学意义(P<0.05)。结论:采用腹腔镜手术治疗胆结石及胆管结石能减轻疼痛,降低并发症发生率,改善患者生活质量。

Objective:To investigate the efficacy and safety of laparoscopic surgery in the clinical treatment of gallstones and cholangiolithiasis.Method:A total of 84 patients with gallstones and cholangiolithiasis treated in Zunyi Bozhou District People's Hospital from May 2022 to May 2023 were selected,and they were divided into two groups according to random number table method,with 42 patients in each group.The control group was treated with open surgery,and the observation group was treated with laparoscopic surgery.The surgical indicators,pain,white blood cell count,C-reactive protein,quality of life and complication rate were compared between the two groups.Result:The operative blood loss in the observation group was less than that in the control group,and the operation time,postoperative anal exhaust time,disappearance of abdominal pain and hospitalization time were shorter than those in the control group,the differences were statistically significant(P<0.05).At 1 d,3 d and 5 d after surgery,the visual analogue scale(VAS)score of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).At the 1 d and 3 d after surgery,the white blood cells and C-reactive protein in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).At 2 weeks,4 weeks,6 weeks and 8 weeks after surgery,the gastrointestinal quality of life index(GIQLI)score in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Laparoscopic surgery for the treatment of gallstones and cholangiolithiasis can relieve pain,reduce the incidence of complications and improve the quality of life of patients.