首页|LC联合LCBDE治疗胆囊结石合并胆总管结石患者的效果及安全性

LC联合LCBDE治疗胆囊结石合并胆总管结石患者的效果及安全性

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目的:评估腹腔镜下胆囊切除术(laparoscopic cholecystectomy,LC)联合腹腔镜下胆总管探查术(laparoscopic common bile duct exploration,LCBDE)治疗胆囊结石(gallstone,GS)合并胆总管结石(common bile duct stones,CBDS)患者的效果和安全性.方法:选取2020年6月—2023年6月灌南县第一人民医院收治的102例GS合并CBDS患者的临床资料进行回顾性研究,按手术方式不同分为观察组(n=51,接受LC联合LCBDE治疗)和对照组[n=51,接受内镜下括约肌切除术(endoscopic-sphincterotomy,EST)联合LC治疗].比较两组围手术期指标、疼痛程度[视觉模拟评分法(visual analogue scale,VAS)]、镇痛泵使用率、应激反应指标、生活质量、并发症及结石复发情况.结果:观察组手术时间长于对照组,下床活动时间、住院时间短于对照组,术后7 d VAS评分、镇痛泵使用率低于对照组,差异有统计学意义(P<0.05);但两组术中出血量比较,差异无统计学意义(P>0.05);观察组术后C反应蛋白(C-reactive protein,CRP)、白细胞计数(white blood cell count,WBC)、中性粒细胞计数(neutrophil count,NEUT)均低于对照组,生活满意度、健康指数、情感得分均高于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率为7.84%,低于对照组的23.53%,差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05).结论:LC联合LCBDE治疗GS合并CBDS患者,相较于EST联合LC,具有更优的围手术期恢复效果及较低的并发症发生率,是一种安全有效的治疗方法,但手术时间较长是其不足之处.
Effect and Safety of LC Combined with LCBDE in the Treatment of Patients with Gallstone and Common Bile Duct Stones
Objective:To evaluate the effect and safety of laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of patients with gallstone (GS) and common bile duct stones (CBDS).Method:The clinical data of 102 patients with GS and CBDS who admitted to the First People's Hospital of Guannan County from June 2020 to June 2023 were retrospectively studied,they were divided into the observation group (n=51,receiving LC combined with LCBDE treatment) and the control group[n=51,receiving endoscopic sphincterotomy (EST) combined with LC treatment]according to different surgical methods.The perioperative indexes,pain degree[visual analogue scale (VAS)],analgesic pump utilization rate,stress response index,quality of life,complications and stone recurrence were compared between two groups.Result:The operation time of the observation group was longer than that of the control group,the time of getting out of bed and hospitalization time were shorter than those of the control group,the VAS score at 7 d after operation and utilization rate of analgesia pump were lower than those of the control group,the differences were statistically significant (P<0.05);however,there was no significant difference in intraoperative blood loss between two groups (P>0.05);the levels of C-reactive protein (CRP),white blood cell count (WBC) and neutrophil count (NEUT) in the observation group after operation were lower than those in the control group,and the scores of life satisfaction,health index and emotion were higher than those in the control group,the differences were statistically significant (P<0.05);the total incidence of complications in the observation group was 7.84%,which was lower than 23.53% in the control group,and the difference was statistically significant (P<0.05);there was no significant difference in the recurrence rate between two groups (P>0.05).Conclusion:Compared with EST combined with LC,LC combined with LCBDE has better perioperative recovery effect and lower complication rate in the treatment of GS and CBDS,it is a safe and effective treatment method,but the long operation time is its deficiency.

Laparoscopic cholecystectomyLaparoscopic common bile duct explorationGallstoneCommon bile duct stonesPerioperativeComplications

韩建树、陈召、葛兴朋

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灌南县第一人民医院 江苏 灌南 222500

腹腔镜下胆囊切除术 腹腔镜下胆总管探查术 胆囊结石 胆总管结石 围手术期 并发症

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(29)