腹腔镜微创治疗肝胆管结石对患者结石清除率并发症及预后情况临床分析.docVIP

腹腔镜微创治疗肝胆管结石对患者结石清除率并发症及预后情况临床分析 　　[摘要] 目的 探讨腹腔镜微创治疗肝胆管结石对患者结石清除率、并发症及预后情况的影响。 方法 选取2014年12月～2016年12月本院收治的肝胆管结石患者80例，将其随机分为研究组与对照组各40例，其中对照组患者给予传统的开腹手术治疗，研究组患者给予腹腔镜微创手术治疗，观察比较两组患者术中情况、术后结石清除率、复发率、并发症发生率及预后情况。 结果 研究组经腹腔镜微创治疗术中情况（手术切口、术中出血量、手术时间）显著优于对照组（P0.05）；研究组患者并发症发生率（2.50%）显著低于对照组（20.00%）（P0.05）；研究组肠功能恢复时间、下床时间及住院时间均短于对照组（P0.05）。复发率：治疗后经随访1年，研究组患者复发率（2.50%）显著低于对照组（18.42%）（P0.05）。 结论 给予肝胆管结石患者实施腹腔镜微创手术治疗，其结石清除效果确切，术中切口缩小、术中出血量及手术时间减少，术后复发率及并发症发生率降低，促进术后肠功能恢复，从而使患者尽早下床活动并出院。 　　[关键词] 肝胆管结石；腹腔镜；结石清除；并发症；预后 　　[中图分类号] R657.4+2；R657.3 [文献标识码] B [文章编号] 1673-9701（2017）33-0047-03 　　[Abstract] Objective To investigate the effect of minimally invasive laparoscopic treatment of hepatolithiasis on stone clearance rate， complications and prognosis in patients. Methods 80 patients with hepatolithiasis admitted in our hospital from December 2014 to December 2016 were randomly divided into study group（n=40）and control group（n=40）. The control group received conventional laparotomy. Patients in the study group were treated with laparoscopic minimally invasive surgery. The intraoperative situations， postoperative stone clearance rate， recurrence rate， complication rate and prognosis were compared between the two groups. Results The intraoperative situations（surgical incision， intraoperative blood loss， operation time）of laparoscopic minimally invasive surgery in the study group were significantly better than those in the control group（P0.05）. The complication rate of study group（2.50%） was significantly lower than that of control group（20.00%，P0.05）. The recovery time of intestinal function， bed ambulation time and hospital stay of study group were shorter than those of control group（P0.05）. After one year of follow-up， the recurrence rate in the study group（2.50%）was significantly lower than that in the control group（18.42%， P0.05）. Conclusion Laparoscopic minimally invasive surgery applied in the patients with hepatolithiasis has exact effect in the removal of stones， with sm