摘要
目的:比较急诊与择期腹腔镜胆总管探查取石术(LCBDE)联合T管引流术治疗急性结石性胆管炎患者的效果。方法:选取2020年8月至2022年8月该院收治的92例急性结石性胆管炎患者进行前瞻性研究,按照不同手术时间将其分为急诊组(n=47)和择期组(n=45)。急诊组给予急诊LCBDE联合T管引流术治疗,择期组给予择期LCBDE联合T管引流术治疗。比较两组中转开腹率、围术期指标水平和并发症发生率。结果:急诊组中转开腹率为4.26%,低于择期组的20.00%,差异有统计学意义(P<0.05);急诊组手术时间、肛门排气时间、活动恢复时间、腹腔引流管留置时间、住院时间均短于择期组,术中出血量少于择期组,差异有统计学意义(P<0.05);急诊组并发症发生率为6.38%,低于择期组的22.22%,差异有统计学意义(P<0.05)。结论:急诊LCBDE联合T管引流术治疗急性结石性胆管炎患者可降低中转开腹率和并发症发生率,改善围术期指标水平的效果优于择期LCBDE联合T管引流术治疗效果。
Objective:To compare effects of emergency and elective laparoscopic common bile duct exploration(LCBDE)combined with T-tube drainage in treatment of patients with acute calculous cholangitis.Methods:A prospective study was conducted on 92 patients with acute calculous cholangitis admitted to the hospital from August 2020 to August 2022.They were divided into emergency group(n=47)and elective group(n=45)according to different operation time.The emergency group was treated with emergency LCBDE combined with T-tube drainage,while the elective group was treated with elective LCBDE combined with T-tube drainage.The rate of conversion to laparotomy,the perioperative index levels,and the incidence of complications were compared between the two groups.Results:The rate of conversion to laparotomy in the emergency group was 4.26%,which was lower than 20.00%in the elective group,and the difference was statistically significant(P<0.05).The operation time,the anal exhaust time,the activity recovery time,the abdominal drainage tube indwelling time and the hospitalization time in the emergency group were shorter than those in the elective group,the intraoperative blood loss was less than that in the elective group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the emergency group was 6.38%,which was lower than 22.22%in the elective group,and the difference was statistically significant(P<0.05).Conclusions:Emergency LCBDE combined with T-tube drainage in the treatment of the patients with acute calculous cholangitis can reduce the rate of conversion to laparotomy and the incidence of complications,and improve the levels of perioperative indexes.Moreover,it is superior to elective LCBDE combined with T-tube drainage.
作者
刘海涛
LIU Haitao(Emergency Department,Fifth Clinical Medical College of Henan University of CM,People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)
出处
《中国民康医学》
2023年第20期153-155,共3页
Medical Journal of Chinese People’s Health
关键词
急诊
择期
腹腔镜胆囊切除术
胆总管探查取石
T管引流术
急性结石胆管炎
开腹率
并发症
Emergency
Elective
Laparoscopic cholecystectomy
Common bile duct exploration
T-tube drainage
Acute calculous cholangitis
Laparotomy rate
Complication
