腹腔镜联合胆道镜在肝内外胆道结石治疗中应用.docVIP

腹腔镜联合胆道镜在肝内外胆道结石治疗中应用 　　[摘要] 目的 探讨腹腔镜联合胆道镜在肝内外胆道结石治疗中的应用价值。 方法 选取2016年12月～2017年11月我院收治的76例肝内外胆道结石患者为研究对象，采用随机分配的原则分组，每组38例。对照组采用传统开腹治疗，观察组采用腹腔镜联合胆道镜治疗，对两组的临床治疗效果进行对比分析。 结果 观察组患者的手术时间、术中出血量、术后下床时间、住院时间均明显优于对照组，差异有统计学意义（P0.05）；观察组患者术后并发症发生率为5.26%，明显低于对照组的26.31%，差异有统计学意义（P0.05）；观察组患者术后VAS评分明显低于对照组（P0.05）。 结论 在肝内外胆道结石临床治疗上，采用腹腔镜联合胆道镜进行治疗可获得较为理想的治疗效果，优化手术指标，缩短住院时间，且治疗安全性高，患者术后疼痛程度轻，故值得进一步推广和应用。 　　[关键词] 腹腔镜；胆道镜；肝内外胆道结石；术后疼痛；安全性 　　[中图分类号] R656 [文献标识码] B [文章编号] 1673-9701（2018）07-0040-03 　　[Abstract] Objective To explore the application value of laparoscopy combined with choledochoscopy in the treatment of intra-and extra-hepatic lithiasis. Methods 76 patients with intrahepatic and extrahepatic lithiasis treated in our hospital from December 2016 to November 2017 were selected as study subjects and divided into two groups according to the principle of randomization， with 38 cases in each group. The control group was treated with traditional laparotomy and the observation group was treated with laparoscopy combined with choledochoscopy. The clinical effect between the two groups was compared and analyzed. Results The operation time， intraoperative blood loss， postoperative ambulation time and hospital stay in the observation group were significantly better than those in the control group， the difference was statistically significant between the two groups（P0.05）. The incidence of postoperative complications in the observation group was 5.26%， significantly lower than that of the control group （26.31%），the difference was statistically significant（P0.05）. The postoperative VAS score of the observation group was significantly lower than that of the control group（P0.05）. Conclusion In the clinical treatment of intrahepatic and extracranial lithiasis， laparoscopy combined with choledochoscopy can achieve ideal therapeutic effect， which can optimize the surgical indicators， shorten the hospital stay，with high treatment security and mild degree of postoperative pain in patients