2种隐瘢痕腹腔镜胆囊切除术比较研究.doc

2种隐瘢痕腹腔镜胆囊切除术的比较研究 黄安华 王维东 陈炳官 胡 海* （同济大学附属东方医院微创外科，上海 200120） ［摘要］ 目的 探讨三孔法隐瘢痕腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的有效性和安全性。方法 2008年8月～2010年4月70例良性胆囊疾病患者随机接受2种隐瘢痕LC，其中三孔法35例，单孔法35例。比较2种隐瘢痕LC的手术时间、术中出血量、术后住院时间、住院费用、术后疼痛和美容效果。随访65例（三孔组33例、单孔组32例）。结果 三孔组术中出血量(21.3±11.8ml）与单孔组(24.3±11.2ml)相比无显著差异(t=1.089,P=0.280)；三孔组术后住院时间（1.5±0.6d）与单孔组（1.5±0.7d）相比无显著差异(t=0.587,P=0.559)；三孔组的住院费用(8639.6±617.4元)与单孔组为(8631.2±810.7元)相比无显著差异(t=-0.049,P=0.961)；三孔组术后第2天VAS评分为(1.1±0.4分)与单孔组(1.2±0.4分)相比无显著差异(t=0.324,P=0.747)；三孔组的美容效果为(1.1±0.4分)与单孔组(1.1±0.3分)相比无显著差异(t=-0.352,P=0.081)。但是，三孔组的手术时间(15.1±5.9min)比单孔组(45.5±11.0min)明显缩短，差异有显著性(t=14.485,P=0.000)；另外，三孔组的术后第1天VAS评分(2.9±1.4分)也比单孔组(4.6±2.0分) 显著降低(t=4.111,P=0.000)。结论 三孔法隐瘢痕腹LC是一种安全和有效的术式。 ［关键词］胆囊切除术；腹腔镜；隐瘢痕；经脐入路 * 通讯作者，E-mail： HYPERLINK mailto:huhailc@ huhailc@. A Comparative Study of Two Different Approaches of Scar-hidden Laparoscopic Cholecystectomy Anhua Huang, Weidong Wang, Bingguan Chen, Hai Hu * (Department of Minimal Invasive Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120) [Abstract] Objective: To explore the safety and feasibility of three-hole scar-hidden laparoscopic cholecystectomy. Methods: 70 patients with benign gallbladder diseases received two different approaches of scar-hiddent laparoscopic cholecystectomy, in which 35 cases received three-hole approach and 35 cases received single-hole approach. The operation time, blood loss, postoperative hospital stay, the cost of hospitalization and postoperative pain were compared between two groups. The follow-up responses were received from 65 cases after surgery (33cases in three-hole group and 32 cases in single-hole group）. Results: There was no statistically significant difference (t=1.089,P=0.280) between two groups in terms of blood loss (21.3±11.8ml in three-hole group v.s. 24.3±11.2ml in single-hole group). There was no statistically significant difference (t=0.587,P=0.559) between two groups in terms of postoper