两种不同术式治疗胆囊结石合并胆总管结石的临床对比OA
Clinical Comparison of Two Different Operation Methods for Cholecystolithiasis Combined with Choledocholithiasis
目的:探讨腹腔镜下经胆囊管途径行胆总管探查取石术(LTCBDE)与腹腔镜下胆总管切开探查取石术(LCBDE)治疗胆囊结石合并胆总管结石的临床效果.方法:对 2020 年 1 月—2023 年 4 月景德镇市第一人民医院诊治的 100 例胆囊结石合并胆总管结石患者的临床资料进行回顾性分析,并根据手术的不同分为两组,参照组(n=50)采用LCBDE进行治疗,观察组(n=50)采用LTCBDE进行治疗.比较两组术中与术后相关指标、生活质量及并发症发生情况.结果:两组胆总管结石数量、手术时间、胆总管结石最大直径比较,差异均无统计学意义(P>0.05);观察组术中出血量少于参照组,差异有统计学意义(P<0.05);观察组住院时间、引流管携带时间均短于参照组,疼痛评分及治疗费用均低于参照组,差异均有统计学意义(P<0.05);两组患者术后 3 d生活质量评分表(QOL)评分中的四个维度均高于术前,且观察组均高于参照组,差异均有统计学意义(P<0.05);观察组术后并发症总发生率为 3.45%,参照组为 10.34%,两组比较差异无统计学意义(P>0.05).结论:针对胆囊结石合并胆总管结石患者,采用LTCBDE进行治疗可减少其术中出血量,缩短住院时间及引流管携带时间,降低其术后疼痛及治疗费用,有利于患者术后康复,提高患者生活质量.
Objective:To investigate the clinical effects of laparoscopic transcystic common bile duct exploration(LTCBDE)and laparoscopic common bile duct exploration(LCBDE)in the treatment of cholecystolithiasis combined with choledocholithiasis.Method:The clinical data of 100 patients with cholecystolithiasis combined with choledocholithiasis diagnosed and treated in the First People's Hospital of Jingdezhen from January 2020 to April 2023 were retrospectively analyzed,and were divided into two groups according to different operations,the reference group(n=50)was treated with LCBDE,and the observation group(n=50)was treated with LTCBDE.The intraoperative and postoperative indexes,quality of life and complications were compared between the two groups.Result:There were no significant differences in the number of choledocholithiasis,operation time and maximum diameter of choledocholithiasis between the two groups(P>0.05).The intraoperative blood loss in the observation group was less than that in the reference group,the difference was statistically significant(P<0.05).The hospital stay and drainage tube carrying time in observation group were shorter than those in reference group,and the pain score and treatment cost were lower than those in reference group,the differences were statistically significant(P<0.05);the four dimensions of the quality of life rating scale(QOL)at 3 d after surgery were higher in both groups than those before surgery,and the observation group were higher than those of the reference group,the differences were statistically significant(P<0.05);the total incidence of postoperative complications was 3.45%in the observation group and 10.34%in the reference group,with no statistical significance between the two groups(P>0.05).Conclusion:For patients with cholecystolithiasis combined with choledocholithiasis,LTCBDE treatment can reduce intraoperative blood loss,shorten hospital stay and drainage tube carrying time,reduce postoperative pain and treatment cost,which is conducive to postoperative rehabilitation and improve the quality of life of patients.
李强;张小斌;毛健;盛燕娟;李斌;赵俊
景德镇市第一人民医院肝胆外科 江西 景德镇 333000
胆囊结石合并胆总管结石腹腔镜下经胆囊管途径行胆总管探查取石术腹腔镜下胆总管切开探查取石术生活质量
Cholecystolithiasis complicated with choledocholithiasisLTCBDELCBDEQuality of life
《中国医学创新》 2024 (005)
19-23 / 5
景德镇市科技计划项目(20211SEZC011)
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