| 摘要: |
| 目的比较腹腔镜与开腹手术治疗胆囊结石合并胆总管结石的临床效果。方法回顾性选取胆囊结石合并胆总管结石行手术治疗的患者184例，按手术方式将患者分为两组。研究组92例，采用腹腔镜手术方式治疗；对照组92例，采用开腹手术方式治疗。比较两组患者手术时间、术中出血量、术后肛门排气时间、住院时间、术后镇痛药物使用率、结石完全清除率、手术前后疼痛及术后并发症发生情况。结果研究组患者手术时间、术中出血量、术后肛门排气时间及住院时间均少于对照组（均P＜0.05）。术前两组患者疼痛评分比较无统计学差异（P＞0.05），术后3d、1周、2周研究组疼痛评分均低于对照组（均P＜0.05）。研究组患者术后镇痛药物使用率低于对照组（P＜0.05），结石完全清除率高于对照组（P＜0.05）。研究组患者术后肺部感染、切口感染及胆汁淤积等并发症发生率均低于对照组（均P＜0.05）。结论腹腔镜手术治疗胆囊结石合并胆总管结石效果较好，患者创伤小，恢复快，术后并发症少，值得临床应用。 |
| 关键词: 腹腔镜 胆囊结石 胆总管结石 疗效 开腹 |
| DOI：10.12056/j.issn.1006-2785.2017.39.24.2017-1028 |
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| Comparison of clinical effects of laparoscopy and laparotomy in treatment of cholecystolithiasis with choledocholithiasis |
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Yuhang District First People's Hospital
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| Abstract: |
| Objective To compare the clinical effect of laparoscopy and laparotomy in the treatment of cholecystolithiasis with choledocholithiasis. Methods Clinical data of 184 patients with of cholecystolithiasis combined with choledocholithiasis undergoing surgical treatment were reviewed retrospectively, including 92 cases treated with laparoscopy (study group), and 92 cases treated with laparotomy (control group). The operative time, intraoperative blood loss, postoperative anal exhaust time, length of hospital stay, postoperative analgesic drug use, stone clearance rate, pain before and after operation and postoperative complications were compared between two groups. Results The operation time, the volume of intraoperative blood loss, the time of postoperative anus exhaust and the length of hospital stay in study group were significantly less than those in control group (all P＜0.05). There was no significant difference in pain score between two groups before operation (P ＞0.05), while the
pain scores in study group were lower than those in control group at 3d, 1 wk and 2 wks after operation (all P ＜0.05). The postoperative analgesic drug use rate of the patients in study group was lower than that of control group (P＜0.05), and the stone clearance rate in study group was higher than that in control group (P ＜0.05). The incidence of postoperative complications including lung infection, incision infection and cholestasis in the study group was lower than that in the control group (P＜0.05).
Conclusion Laparoscopic surgery for cholecystolithiasis combined with choledocholithiasis is superior to laparotomy with little trauma, quick recovery and less postoperative complications. |
| Key words: Laparoscopy Cholecystolithiasis Choledocholithiasis Curative effect Laparotomy |
