中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
11期
1242-1244
,共3页
侯克柱%汪云霞%傅志强%龚华
侯剋柱%汪雲霞%傅誌彊%龔華
후극주%왕운하%부지강%공화
胆囊切除术,腹腔镜%胆道外科手术%胆总管结石
膽囊切除術,腹腔鏡%膽道外科手術%膽總管結石
담낭절제술,복강경%담도외과수술%담총관결석
Cholecystectomy,laparoscopy%Biliary tract surgical procedures%Choledocholithiasis
目的 探讨腹腔镜联合胆道镜治疗胆总管结石的临床疗效. 方法 选取我院2013年1月至2014年12月择期行手术治疗的老年胆总管结石患者134例为研究对象,按数字表法随机分为观察组和对照组各67例.观察组手术采用腹腔镜联合胆道镜,对照组手术采用传统开腹,对比分析两组手术时间、术中出血量、术后排气时间和住院天数,以及并发症发生和结石残留情况. 结果 观察组手术时间(124.6±21.2)min长于对照组(94.7±17.9)min(t=8.821,P＜0.001);观察组术中出血量(43.8±10.4)ml少于对照组(113.5±37.6) ml(t=14.624,P＜0.001);观察组排气时间(27.6±5.5)h和住院天数(7.4±2.4)d均比对照组的(43.4±8.1)h和住院天数(10.3±2.8)d短(t=13.209、6.437,均P＜0.001);观察组术后疼痛发生率6.0％和并发症总发生率16.4％均比对照组的28.4％和43.3％低(x2 =11.810、11.547,均P=0.001). 结论 腹腔镜联合胆道镜用于治疗老年胆总管结石,有利于减少手术创伤,降低术中出血量,促进患者术后恢复.
目的 探討腹腔鏡聯閤膽道鏡治療膽總管結石的臨床療效. 方法 選取我院2013年1月至2014年12月擇期行手術治療的老年膽總管結石患者134例為研究對象,按數字錶法隨機分為觀察組和對照組各67例.觀察組手術採用腹腔鏡聯閤膽道鏡,對照組手術採用傳統開腹,對比分析兩組手術時間、術中齣血量、術後排氣時間和住院天數,以及併髮癥髮生和結石殘留情況. 結果 觀察組手術時間(124.6±21.2)min長于對照組(94.7±17.9)min(t=8.821,P＜0.001);觀察組術中齣血量(43.8±10.4)ml少于對照組(113.5±37.6) ml(t=14.624,P＜0.001);觀察組排氣時間(27.6±5.5)h和住院天數(7.4±2.4)d均比對照組的(43.4±8.1)h和住院天數(10.3±2.8)d短(t=13.209、6.437,均P＜0.001);觀察組術後疼痛髮生率6.0％和併髮癥總髮生率16.4％均比對照組的28.4％和43.3％低(x2 =11.810、11.547,均P=0.001). 結論 腹腔鏡聯閤膽道鏡用于治療老年膽總管結石,有利于減少手術創傷,降低術中齣血量,促進患者術後恢複.
목적 탐토복강경연합담도경치료담총관결석적림상료효. 방법 선취아원2013년1월지2014년12월택기행수술치료적노년담총관결석환자134례위연구대상,안수자표법수궤분위관찰조화대조조각67례.관찰조수술채용복강경연합담도경,대조조수술채용전통개복,대비분석량조수술시간、술중출혈량、술후배기시간화주원천수,이급병발증발생화결석잔류정황. 결과 관찰조수술시간(124.6±21.2)min장우대조조(94.7±17.9)min(t=8.821,P＜0.001);관찰조술중출혈량(43.8±10.4)ml소우대조조(113.5±37.6) ml(t=14.624,P＜0.001);관찰조배기시간(27.6±5.5)h화주원천수(7.4±2.4)d균비대조조적(43.4±8.1)h화주원천수(10.3±2.8)d단(t=13.209、6.437,균P＜0.001);관찰조술후동통발생솔6.0％화병발증총발생솔16.4％균비대조조적28.4％화43.3％저(x2 =11.810、11.547,균P=0.001). 결론 복강경연합담도경용우치료노년담총관결석,유리우감소수술창상,강저술중출혈량,촉진환자술후회복.
Objective To explore the clinical effect of laparoscopy combined with choledochoscopy on choledocholithiasis.Methods Totally 134 elderly patients with choledocholithiasis were treated in our hospital from Jan 2013 to Dec 2014, who were randomly divided into observation group and control group (n=67 for each), treated with laparoscopy combined with choledochoscopy, and traditional surgery, respectively.The operation time, bleeding volume, exhaust time, in-hospital stay, complications and residual stones rate were compared between the two groups.Results The operation time was higher in observation group than in control group [(124.6±21.2) min vs.(94.7± 17.9) min, t=8.821, P＜0.001].The bleeding volume were less in observation group than in control group[(43.8±10.4) ml vs.(113.5±37.6) ml, t=14.624, P＜0.001].The exhaust time and in hospital time were decreased in observation group than in control group[(27.6 ±5.5) h vs.(43.4±8.1) h, (7.4±2.4) d vs.(10.3±2.8) d, t=13.209 and 6.437, P＜0.001 for both].The incidences of postoperative pain and other complications were lower in observation group than in control group [6.0％ vs.28.4％, 16.4％ vs.43.3％, x2=11.810and 11.547, P=0.001 for all].Conclusions The laparoscopy combined with choledochoscopy has advantages to minimize the surgical injury, reduce the bleeding volume and promote the postoperative recovery in treating choledocholithiasis in elderly patients.
