腹腔镜与开腹胆道手术治疗胆总管结石临床对照研究.docVIP

腹腔镜与开腹胆道手术治疗胆总管结石临床对照研究 　　[摘要] 目的 评估腹腔镜胆道手术治疗胆总管结石的有效性和安全性。方法 该研究随机选取2012年1月―2015年12月该院收治的胆总管结石患者100例，根据手术方式分为两组：腹腔镜手术组（48例）和开腹手术组（52例），两组患者均因胆道结石行胆道手术，比较两组患者手术时间、住院时间、胃肠道通气时间及住院费用，以及两组患者术后胆漏发生率、术后镇痛人数比例、伤口感染率。结果 腹腔镜组开始下床活动时间、肠道通气时间和住院时间分别为（46.9±3.3）h， （36.9±6.6）h和 （9.1±1.3）d，均明显短于开腹组且术后胆漏发生率、术后镇痛人数和术后感染发生率均明显低于开腹组，差异有统计学意义（P0.05）。结论 腹腔镜胆道手术具有手术时间短、手术创口小，术后容易恢复以及感染率低等优点，值得临床上进行推广。 　　[关键词] 腹腔镜；胆道手术；胆总管结石 　　[中图分类号] R61 [文献标识码] A [文章编号] 1674-0742（2016）11（a）-0078-03 　　[Abstract] Objective To estimate the efficacy and the safety of laparoscopic surgery in the treatment of common bile duct calculi.. Methods The study random selection a total of 100 cases of patients with choledocholithiasis in 2012 January 2015 December in our hospital， according to the operation mode， divided into two groups： laparoscopic surgery group （48 cases） and laparotomy group （52 cases）， two groups of patients were due to biliary calculi， biliary tract surgery， compared two groups of patients with operation time， hospitalization time， gastrointestinal ventilation time and hospitalization expenses， and two groups of patients with postoperative bile leakage， the incidence of postoperative analgesia percentage， wound infection rate. Results In the laparoscopic group to get out of bed activity time， intestinal ventilation time and hospital stay were （46.9 ± 3.3） h （36.9 ± 6.6） h and （9.1 ± 1.3） d， were significantly shorter in laparotomy group and postoperative bile leakage incidence， postoperative analgesia and the number of postoperative infection rate were significantly lower than that of the open group， the difference was statistically significant （P 0.05）. Conclusion Laparoscopic biliary tract surgery with shorter operative time， small operation wound， postoperative easy recovery and low rate of infection， it is worth clinical promotion. 　　[Key words] Laparoscopy；Open surgery；Common bile duct calculi 　　?总管结石是临床上常见的消化系统疾病。手术是临床上常用的治疗手段。由于腔镜手术创口小，易恢复，病人痛苦少，目前腹腔镜下切除胆囊是手术的“金标准”[1]。除此之外，胆总管切开