摘要
目的观察胆囊结石合并胆总管结石应用腹腔镜结合胆道镜治疗的效果。方法回顾性分析102例胆囊结石合并胆总管结石患者的临床资料,其中50例行开腹手术(对照组),52例行腹腔镜结合胆道镜取石手术(观察组),比较两组患者的手术情况、机体应激反应及术后并发症、复发情况。结果与对照组相比,观察组患者的手术时间、住院时间、胃肠功能恢复时间均显著缩短,术中出血量显著减少,术后疼痛减轻更明显,术后1 d痛感VAS评分显著降低(P<0.05)。术后1 d血清中TNF-α、CRP水平均有所上升,以对照组升高程度较观察组更明显(P<0.05);术后7 d两组患者血清中TNF-α、CRP水平则均显著降低,以观察组降低程度更明显(P<0.05);观察组、对照组的术后并发症发生率分别为3.85%(2/52)、20.00%(10/50),以观察组并发症更少(P<0.05)。观察组未见复发,对照组的复发率16.00%(8/50)显著升高(P<0.05)。结论胆囊结石合并胆总管结石应用腹腔镜结合胆道镜治疗效果更好,利于减轻创伤,减轻术后痛感,减少术后应激反应,并发症少。
Objective:To observe the effect of laparoscopic choledochoscope on cholecystolithiasis combined with choledocholithiasis.Methods:The clinical data of 102 patients with cholecystolithiasis complicated with choledocholithiasis were retrospectively analyzed,among which 50 patients underwent open surgery(control group)and 52 patients underwent laparoscopic choledocholithiasis(observation group).The surgical conditions,changes in the body stress response,postoperative complications and recurrence of the two groups were compared.Results:Compared with the control group,the operation time,hospital stay and gastrointestinal function recovery time in the observation group were significantly shortened,the amount of intraoperative blood loss was significantly reduced,postoperative pain relief was more obvious,and the pain VAS score 1d after surgery was significantly decreased(P<0.05).The serum levels of TNF-αand CRP were increased on postoperative day 1,and the degree of increase was more obvious in the control group than in the observation group(P<0.05).The serum levels of TNF-αand CRP in 2 groups were significantly decreased on day 7 after operation,and the degree of decrease in the observation group was more obvious(P<0.05).The incidence of postoperative complications in the observation group and the control group were 3.85%(2/52)and 20.00%(10/50)respectively,with fewer complications in the observation group(P<0.05).No recurrence was observed in the observation group,and the recurrence rate in the control group was significantly increased(P<0.05).Conclusion:The treatment of cholecystolithiasis combined with choledocholithiasis by laparoscopy combined with choledochoscopy is more effective,which is beneficial to reduce trauma,relieve postoperative pain,reduce postoperative stress reaction and have fewer complications.
作者
李军
Li Jun(Department of General Surgery,Xixia People's Hospital,Nanyang 474550,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
2021年第11期849-852,共4页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
关键词
腹腔镜
胆道镜
胆囊结石
胆总管结石
aparoscope
choledochoscope
gallstone
choledocholithiasis
