CAJ | 학술논문

目的：：比较一期缝合与术中留置T管在腹腔镜胆总管探查取石术( LCBDE)中的应用效果。方法：将186例行LCBDE患者随机分为一期缝合组98例与术中留置T管组88例。比较2组手术时间、术中出血量、术后住院时间、胆汁丢失量、住院费用、肛门排气时间、抗生素使用时间、输液量、输液时间、胃功能恢复时间、术后下床活动时间、不良反应及生活质量评分。结果：一期缝合组术中出血量、术后住院时间、胆汁丢失量、住院费用、肛门排气时间、抗生素使用时间、输液量、输液时间、胃功能恢复时间和术后下床活动时间均少于术中留置T管组(P<0.05~P<0.01)；一期缝合组不良反应总发生率为6.82％，术中留置T管组为7.14％，差异无统计学意义(P>0.05)；根据SF-36生活质量评价标准，一期缝合组患者生活质量各维度及总得分均显著高于术中留置T管组(P<0.01)。结论：与术中留置T管相比，一期缝合在LCBDE中的应用效果更佳，应加以推广及应用。
목적：：비교일기봉합여술중류치T관재복강경담총관탐사취석술( LCBDE)중적응용효과。방법：장186례행LCBDE환자수궤분위일기봉합조98례여술중류치T관조88례。비교2조수술시간、술중출혈량、술후주원시간、담즙주실량、주원비용、항문배기시간、항생소사용시간、수액량、수액시간、위공능회복시간、술후하상활동시간、불량반응급생활질량평분。결과：일기봉합조술중출혈량、술후주원시간、담즙주실량、주원비용、항문배기시간、항생소사용시간、수액량、수액시간、위공능회복시간화술후하상활동시간균소우술중류치T관조(P<0.05~P<0.01)；일기봉합조불량반응총발생솔위6.82％，술중류치T관조위7.14％，차이무통계학의의(P>0.05)；근거SF-36생활질량평개표준，일기봉합조환자생활질량각유도급총득분균현저고우술중류치T관조(P<0.01)。결론：여술중류치T관상비，일기봉합재LCBDE중적응용효과경가，응가이추엄급응용。
Objective:To compare the effects between primary suture and intraoperative indwelling T tube in laparoscopic common bill duct exploration ( LCDBDE ) . Methods:One hundred and eighty-six patients treated with LCBDE were randomly divided into the primary suture group ( 98 cases ) and intraoperative indwelling T tube group ( 88 cases ) . The operation time, bleeding volume, postoperative hospitalization time,bile loss,hospitalization expense,anal exhaust time,the use time of antibiotics,amount of infusion, transfusion time,gastric function recovery time,postoperative ambulation time,adverse reactions and quality of life between two groups were compared. Results:The postoperative bleeding volume,hospitalization time,bile loss,hospitalization expense,anal exhaust time, the use time of antibiotics,amount of infusion,transfusion time,gastric function recovery time and postoperative ambulation time in the primary suture group were less than those in intraoperative indwelling T tube group(P<0. 05 to P<0. 01). The total incidence rates of adverse reaction in primary suture group and intraoperative indwelling T tube group were 6. 82% and 7. 14%, respectively, the difference of which was not statistically significant(P >0. 05). According to the evaluation standard of the SF-36 life quality,the dimensions and total score of quality of life in primary suture group were significantly higher than those in intraoperative indwelling T tube group(P<0. 01). Conclusions:Compared with the intraoperative indwelling T tube,the effects of primary suture in LCBDE is good,which should be promoted and application.