腹腔镜联合胆道镜手术治疗对胆总管结石患者结石清除效果及应激反应的影响研究OA
Study on the Effect of Laparoscopic Combined with Choledochoscopy Surgery on Stone Clearance and Stress Response in Patients with Common Bile Duct Stones
目的 分析腹腔镜联合胆道镜手术治疗对胆总管结石患者结石清除效果及应激反应的影响.方法 将长葛市人民医院 2021 年 2 月至 2022 年 12 月析胆总管结石患者(82 例)作为研究对象,依据区间随机法将其分为对照组、研究组,各 41 例,对照组治疗术式为传统开腹手术,研究组行腔镜联合胆道镜手术治疗.比较两组手术相关指标、术后结石复发率、围术期身体应激反应指标变化情况、术后疼痛评分及术后并发症发生情况.结果 实验组手术时间、住院时间、术后首次下床活动时间均短于对照组,术中出血量低于对照组,差异有统计学意义(P＜0.05);实验组术后结石复发率(2.44%)与对照组(14.63%)相比较低,差异有统计学意义(P＜0.05);术前组间身体应激反应指标对比差异无统计学意义(P＞0.05),术后 72 h两组肾上腺素、去甲肾上腺素、皮质醇水平均明显升高,实验组升高幅度与对照组相比更低,差异有统计学意义(P＜0.05);术后 1 d、2 d、3 d实验组疼痛评分与对照组相比更低,差异有统计学意义(P＜0.05);实验组术后并发症发生率(4.88%)与对照组(19.51%)相比较低,差异有统计学意义(P＜0.05).结论 胆总管结石行腹腔镜联合胆道镜手术可取得较理想的结石清除效果,且术后应激反应相对安全,值得应用.
Objective To explore the impacts of laparoscopic combined with choledochoscopic surgery on the stone removal effects and stress response for the common bile duct stone patients.Methods A total of 82 patients with the common bile duct stone treated from February 2021 to December 2022 in Changge City People's Hospital were chosen as research subjects.According to the random interval method,patients were assigned to control group and study group,with 41 cases in each group.The control group underwent traditional open surgery,while the study group underwent endoscopic combined with choledochoscopy surgery.The operation indicators,stone recurrence rate,stress response indexes,pain scores and postoperative complications were compared.Results The operation time,hospital stays and initial off-bed activity time in the study group were significantly shorter than control group;the intraoperative bleeding volume was significantly smaller than control group,and the difference was statistically significant(P＜0.05);the stone recurrence rates in the study group(2.44%)were significantly lower than control group(14.63%),and the difference was statistically significant(P＜0.05);before surgery,the stress response indicators between groups were not significantly different(P＞0.05);after 72 h of surgery,the levels of epinephrine,norepinephrine and cortisol in both groups were significantly increased.the increase in the study group was lower than that in the control group,and the difference was statistically significant(P＜0.05);after 1 d,2 d and 3 d of surgery,the pain scores in the study group were significantly lower than control group,and the difference was statistically significant(P＜0.05);the postoperative complication rates in the study group(4.88%)were significantly lower than control group(19.51%),and the difference was statistically significant(P＜0.05).Conclusion Laparoscopic combined with choledochoscopy surgery for common bile duct stones can achieve ideal stone removal results,and postoperative stress response is relatively safe.It is worthy of clinical application.
杨富强
长葛市人民医院 普外一科,河南 长葛 461500
临床医学
胆总管结石腹腔镜联合胆道镜手术术后并发症应激反应结石复发率
common bile duct stonelaparoscopic and choledochoscopic surgerypostoperative complicationsstress responsestone recurrence rate
《临床研究》 2024 (005)
83-86 / 4
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