腹腔镜联合输尿管镜碎石术对56例肝胆结石患者疗效及并发症的影响.docVIP

腹腔镜联合输尿管镜碎石术对56例肝胆结石患者疗效及并发症的影响 　　摘 要 目的：探讨腹腔镜联合输尿管镜碎石术对肝胆结石患者疗效及并发症的影响。方法：选取肝胆管结石患者112例随机分为联合组和开腹组各56例，开腹组患者给予开腹碎石术治疗，联合组患者给予腹腔镜联合输尿管镜碎石术治疗，统计分析所有患者住院时间、T管拔出时间、术中出血量、肠功能恢复时间、术后结石取净和并发症发生情况以及术前（T0）、插管时（T1）、开切口或穿刺时（T2）、取石时（T3）、术毕时（T4）的心率变化。结果：联合组患者住院和肠功能恢复时间、术中出血量、并发症发生率和再手术率及在T2、T3、T4时刻心率变化明显少于或低于开腹组、T管拔出时间和结石取净率则明显长于或高于开腹组（P0.05）。结论：腹腔镜联合输尿管镜碎石术可有效减少取石过程中对患者的创伤和刺激，减轻患者的应激反应，有利于促进患者身体恢复及减少并发症的发生，进而提高临床疗效和改善预后。 　　关键词 腹腔镜联合输尿管镜碎石术 肝胆管结石 疗效 并发症 　　中图分类号：R657.42 文献标识码：A 文章编号：1006-1533（2016）21-0047-04 　　Effect of laparoscopic ureteroscopy combined lithotripsy on the curative efficacy and complications in the treatment of 56 cases of patients with hepatolith* 　　JANG Jinru**， CHEN Mingchu， HUANG Wenxing（Traditional Chinese Medicine Hospital of Duchang County in Jiujiang City， Jiujiang 332000， China） 　　ABSTRACT Objective： To discuss the effect of laparoscopic ureteroscopy combined lithotripsy on the curative efficacy and complications in the treatment of patients with hepatolith. Methods： One hundred and twelve patients with hepatolith were randomly divided into a combination group and a laparotomy group with 56 cases each. The laparotomy group underwent open laparotomy lithotripsy， and the combination group underwent laparoscopic ureteroscopy combined lithotripsy. The time for hospitalization and pulling out T tube， the amount of intraoperative blood loss， the time for the recovery of bowel function， the situation of postoperative calculus removal and complications and the changes of heart rate preoperative （T0）， at intubation （T1）， incision or puncture （T2）， the stone removal （T3） and surgery completion （T4） were analyzed. Results： The time for hospitalization and the recovery of bowel function， the amount of intraoperative blood loss， the incidence of complications and reoperation and the changes of heart rate at T2， T3 and T4 were significantly less or lower while the time for pulling out T tube and stone removal rate were significantly longer or higher in the