摘要
目的探讨腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石的疗效及对患者炎症因子的影响。方法选取2020年3月至2021年5月萍乡市人民医院收治的80例胆囊结石合并胆总管结石患者作为研究对象,按照随机数字表法分为常规组与联合组,每组40例。常规组行传统开腹手术治疗,联合组行腹腔镜联合胆道镜手术治疗。比较两组围手术期指标、视觉模拟评分法(VAS)评分、预后情况。结果联合组术中出血量少于常规组,手术时间长于常规组,术后下床活动时间、术后排气时间均短于常规组,差异有统计学意义(P<0.05)。术前,两组VAS评分比较差异无统计学意义;术后,两组VAS评分均低于术前,且联合组低于常规组,差异有统计学意义(P<0.05)。术前,两组WBC、中性粒细胞百分比、C反应蛋白(CRP)水平比较差异无统计学意义;术后,两组WBC、中性粒细胞百分比、CRP水平均高于术前,但联合组低于常规组,差异有统计学意义(P<0.05)。联合组术后并发症发生率低于常规组,差异有统计学意义(P<0.05);两组术后结石残留、胆管炎复发、结石复发占比比较差异无统计学意义。结论腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石疗效确切,创伤小,并发症少,可促进术后恢复,安全性较高,值得临床推广应用。
Objective To investigate the efficacy of laparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis complicated with choledocholithiasis and its effect on inflammatory factors in patients.Methods A total of 80 patients with cholecystolithiasis and choledocholithiasis admitted to Pingxiang People's Hospital from March 2020 to May 2021 were selected as the research subjects,they were divided into the conventional group and the combined group according to the random number table method,with 40 cases in each group.The conventional group was treated with traditional open surgery,and the combined group was treated with laparoscopy combined with choledochoscopy.The perioperative indexes,visual analogue scale(VAS)score and prognosis were compared between the two groups.Results The intraoperative blood loss in the combined group was less than that in the conventional group,the operation time was longer than that in the conventional group,and the time of getting out of bed and postoperative exhaust time were shorter than those in the conventional group,the differences were statistically significant(P<0.05).Before operation,there was no significant difference in VAS score between the two groups;after operation,VAS scores of the two groups were lower than before operation,and the combined group was lower than the conventional group,the difference was statistically significant(P<0.05).Before operation,there were no significant differences in WBC,neutrophil percentage and CRP levels between the two groups;after operation,WBC,neutrophil percentage and CRP levels of the two groupswere higher than before operation,but the combined group was lower than the conventional group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the combined group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).There were no significant differences in the proportion of postoperative stone residue,cholangitis recurrence and
作者
周勇
聂剑
王小方
钟福平
ZHOU Yong;NIE Jian;WANG Xiaofang;ZHONG Fuping(Department of Hepatobiliary Surgery,Pingxiang People's Hospital,Pingxiang,Jiangxi,337000,China)
出处
《当代医学》
2023年第32期107-110,共4页
Contemporary Medicine
关键词
腹腔镜
胆道镜手术
胆囊结石
胆总管结石
炎症因子
Laparoscopy
Choledochoscopy surgery
Gcholecystolithiasis
Choledocholithiasis
Inflammatory factor
