腹腔镜联合输尿管硬镜治疗肝内外胆管结石中鞘管应用研究.docVIP

腹腔镜联合输尿管硬镜治疗肝内外胆管结石中鞘管应用研究 　　[摘要]目的 探讨腹腔镜联合输尿管硬镜治疗肝内外胆管结石中鞘管的应用研究。方法 收集2014年2月～2015年10月我院50例肝内外胆管结石患者作为研究对象，根据手术方式的不同将其分为两组，每组各25例。研究组采取腹腔镜联合输尿管硬镜治疗，对照组采用传统开腹手术治疗，对比两组患者的临床治疗效果。结果 研究组手术时间（104.78±14.36）min、住院时间（8.11±2.35）d、术中出血量（82.02±14.71）ml、住院费用（1.10±0.12）万元、术后肠道功能恢复时间（2.01±0.36）d以及T管拔除时间（14.20±5.38）d均少于对照组，差异有统计学意义（P0.05）；研究组结石取尽率（100.00%）、并发症发生率（4.00%）与对照组（84.00%、40.00%）比较，差异有统计学意义（P0.05）。结论 腹腔镜联合输尿管硬镜治疗肝内外胆管结石中鞘管应用具有治疗安全性高、手术时间短、术后临床疗效显著的优点，有助于保障术后患者康复，值得临床借鉴及推广。 　　[关键词]肝内外胆管结石；腹腔镜；输尿管硬镜；鞘管 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-4721（2016）07（b）-0044-03 　　[Abstract]Objective To explore applied research of sheath canal of laparoscopy combined with rigid ureteroscopy in the treatment of intrahepatic and extrahepatic bile duct stones.Methods Altogether 50 cases of patients with intrahepatic and extrahepatic bile duct stones in our hospital from February 2014 to October 2015 were collected as study objects and divided into two groups，and each group was 25 patients according to different surgery methods.Study group was treated by combined apply of laparoscopy and rigid ureteroscopy，and control group was treated with traditional open surgery.And the clinical effectiveness of two groups was compared.Results According to the statistical results，duration of surgery，length of stay，the amount of intraoperative bleeding，hospitalization expenses，postoperative intestinal function recovery time and T-tube removal time of study group was （104.78±14.36） min，（8.11±2.35） d，（82.02±14.71） ml，（11±1.2） ten thousand yuan，（2.01±0.36） d and （14.20±5.38） d respectively，less than that of control group with significant difference （P0.05）.The stone removal rate （100.00%） and incidence of complications （4.00%） of study group was obviously lower than that of control group respectively （84.00% and 40.00%） with significant difference （P0.05）.Conclusion Application of sheath canal of laparoscopy combined with rigid ureteroscopy demonstrates its advantages of high safety，short surgery time an