腹腔镜手术治疗胆囊结石合并胆管结石的临床效果分析.docVIP

腹腔镜手术治疗胆囊结石合并胆管结石的临床效果分析 　　[摘要] 目的 探讨腹腔镜手术治疗胆囊结石并发胆总管结石的疗效。方法 方便选择2012年1月―2015年12月间该院收治的80例胆囊结石并发胆总管结石的患者，随机分为研究组和对照组，研究组患者采用腹腔镜手术治疗，对照组采用开腹胆囊切除术联合胆总管取石术治疗。统计两组患者治疗过程中平均出血量、手术时间、进食时间、住院时间和结石清除率，同时记录治疗过程中不良反应及并发症。结果 ①两组患者结石清除率分别为97.5%、95.0%，组间比较差异无统计学意义；研究组手术时间、失血量、术后住院时间、进食时间明显少于对照组，差异具有统计学意义，P0.05。②两组患者并发症主要有切口感染、肺部感染、胸腔积液、膈下感染。研究组有3例（7.5%）患者有并发症发生，显著少于对照组8例（20.0%），差异有统计学意义，P0.05。结论 腹腔镜手术治疗胆囊结石并发胆总管结石疗效较好，术后恢复较快，对患者创伤小，并发症发生率低，安全可靠。 　　[关键词] 腹腔镜；胆囊结石；胆总管结石 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）10（c）-0027-03 　　[Abstract] Objective To study the clinical effect of laparoscopic operation for the treatment of gallbladder stones with bile duct stones. Methods Convenient selection 80 patients with gallbladder stones complicated with bile duct stones treated between January 2012 to December 2015 randomly were divided into study group and control group.Patients in the study group were treated by laparoscopic surgery， while laparotomy for the control group. The average amount of bleeding， operation time， postoperative hospital stay time， feeding time and stone clearance rate in the two groups were analyzed， besides adverse reactions and complications were recorded at the same time. Results ①The stone clearance rate of the two groups were 97.5% and 95%， and with no significant difference between the two groups. The operation time， blood loss， postoperative hospital stay time， feeding time in the study group was significantly less than that in the control group， and the difference was statistically significant. ②The complications in the two groups included wound infection， pulmonary infection， pleural effusion， diaphragmatic infection. There were 3 cases （7.5%） patients with complications in the study group， which was significantly less than that in the control group （20.0%）， with significant difference， P 0.05. Conclusion Laparoscopic surgery in the treatment of gallbladder stone complicated with common bile duct stones makes better clinic effect than laparotom