腹腔镜联合胆道镜保胆取石术的临床效果研究-外科学专业论文.docxVIP

泰山医学院硕士学位论文 泰山医学院硕士学位论文 万方数据 万方数据 腹腔镜联合胆道镜保胆取石术的临床效果研究 研究生：刘 杰 专 业：外科学（普外） 导 师：刘振忠 中文摘要 目的 探讨腹腔镜联合胆道镜保胆取石术在临床治疗胆囊结石中的临床效果。 方法 将我院 2011 年 1 月至 2014 年 1 月间收治的 106 例胆囊结石患者依据治疗方式分 为 2 组。观察组 41 例，手术方式采用腹腔镜联合胆道镜保胆取石术，对照组 65 例， 手术方式采用腹腔镜胆囊切除术。术后，对两组患者的手术时间、术中出血量，术后 患者肠功能的恢复时间、术后正常饮食恢复的时间、患者住院天数、住院费用等进行 对比分析，对两组术后出现的并发症进行比较，并对观察组手术前后胆囊收缩功能和 胆囊壁厚度进行对比分析。 结果 观察组和对照组在手术操作时间、术中出血量、肠功能恢复时间、住院天数、住 院费用等方面比较，差异无统计学意义（P＞0.05）。观察组术后正常饮食恢复时间低 于对照组，差异有统计学意义（P＜0.05）。观察组住院期间出现并发症例数比较，差 异无统计学意义（P＞0.05）。远期并发症发生例数显著性低于对照组（P＜0.05）。观 察组术后 1 年、3 年复查彩超结果显示，胆囊收缩功能基本恢复正常、胆囊壁厚度显 著低于术前，差异有统计学意义（P＜0.05）。 结论 腹腔镜联合胆道镜保胆取石术可有效治疗胆囊结石，具有较高的安全性，并能有 效保留患者有功能的胆囊，值得在临床上推广应用。 关键词：腹腔镜；胆道镜；胆囊结石；保胆取石术 1 THE CLINICAL EFFECTIVENESS STUDY OF CHOLANGIOS- COPY COMBINED LAPAROSCOPY OF TAKE STONE IN PROTECT GALLBLADDER Graduate: Liu Jie Speciality: Surgery （General Surgery） Teacher: Pro. Liu Zhenzhong Objective ABSTRACT To investigate the clinical efficacy of laparoscopic combinend choledochoscope Paul gall stone surgery in treatment of gallstones. Methods 106 cases of gallstones patients from January 2011 to January 2014 were selected and divided into two groups by treatment methods，observation group (n=41) and control group (n=65).Patient in observation group were given laparoscopic combinend choledochoscope Paul gall stone surgery ， and patients in control group were given laparoscopic cholecystectomy. After surgery，the operative time，blood loss，postoperative recovery time of bowel movement，normal diet time after recovery，hospital stay and hospital costs were compared，the complication of after surgery were compared，compare the systolic function of gallbladder and the thickness of the gallbladder wall of observation group，which before and after treatment. Results The differences of the operative time，blood loss，postoperative recovery time of bowel movement，hospital stay and hospital costs between observation group and control group were no significant (P0.05). Recovery normal eating time of observation group were si