腹腔镜和胆道镜治疗高龄胆囊合并胆总管结石效果观察(1)
【摘要】 目的：分析腹腔镜和胆道镜在治疗高龄胆囊合并胆总管结石中的效果。方法：随机选取2015年6月-2017年6月笔者所在医院收治的60例胆囊合并胆总管结石患者为研究对象，将所有患者随机分为对照组与观察组，各30例。对照组采用常规手术治疗，观察组则采用腹腔镜联合胆道镜治疗，分析比较两组的手术疗效。结果：观察组患者排气时间、住院时间、手术时间和手术出血量均优于对照组，差异均有统计学意义(t=8.294、5.383、13.498、9.144，P<0.05)；观察组并发症发生率及复发率低于对照组，但比较差异无统计学意义(字2=3.750、1.456，P>0.05)；两组患者手术前后的疼痛程度比较，差异均无统计学意义(t=0.872、0.522，P>0.05)。结论：腹腔镜联合胆道镜治疗高龄胆囊合并胆总管结石可减少对患者的创伤，并发症发生率和复发率均不高，缓解患者的疼痛，在临床应用中值得推广。
【关键词】 腹腔镜； 胆道镜； 高龄胆囊合并胆总管结石； 疗效
doi：10.14033/j.cnki.cfmr.2018.15.010 文献标识码 B 文章编号 1674-6805(2018)15-00-03
The Observation of Curative Effect of Aged Gallbladder Combine the Choledocholithiasis Treated by Laparoscope and Choledochoscope/GUO Jiawei，WANG Yulong，WANG Ning.//Chinese and Foreign Medical Research，2018，16(15)：-27
【Abstract】 Objective：To analyse the treatment effect of aged gallbladder combine the choledocholithiasis treated by laparoscope and choledochoscope.Method：From June 2015 to June 2017，60 cases of patients with aged gallbladder combine the choledocholithiasis in our hospital were selected and randomly divided into two groups，30 cases in each group.The control group used the regular operation for treatment，the treatment group used the laparoscope combine choledochoscope for treatment.Analysed and compared the surgical treatment of the two groups.Result：The blood loss volume during the operation，time of operation，hospital stays and evacuation time of the treatment group were better than those of the control group，the differences were statistically significant(t=8.294，5.383，13.498，9.144，P<0.05).The complication rate and recurrence rate in the observation group were lower than those in the control group，but the difference was not statistically significant(字2=3.750，1.456，P>0.05).Compared the pain degree of the two groups before and after surgery，there were no statistical significance(t=0.872，0.522，P>0.05).Conclusion：Laparoscopy combined with choledochoscopy in the treatment of old gallbladder combined with choledocholithiasis can reduce the trauma to the patients，the incidence of complications and the recurrence rate are not high，alleviate the pain of the patients.It is worth popularizing in clinical application.
【Key words】 Laparoscope； Choledochoscope； Aged gallbladder combine the choledocholithiasis； Curative effect
First-author’s address：Mianyang People’s Hospital，Mianyang 621000，China
膽囊合并胆总管结石是老年人多发病之一，随着我国老龄化人口的加剧，高龄胆囊合并胆总管结石在我国的发病率呈逐年上升的趋势，已成为严重的公共安全卫生问题。胆囊合并胆总管结石患者发病时疼痛难忍，严重时危及患者的生命[1]。由于患者大多为老年人群，自身机体功能减退，抵抗力较弱，对手术的耐受度下降，对于以往常规的开腹手术治疗承受力下降，导致容易出现术后并发症。随着医学技术的发展，临床上逐渐采用腹腔镜联合胆道镜治疗胆囊合并胆总管结石，因其具有创伤性小，患者预后快等特点，且在手术中不会对患者十二指肠乳头括约肌的功能造成破坏[2-3]。本研究对高龄胆囊合并胆总管结石患者采用腹腔镜和胆道镜治疗的临床效果进行分析，现总结报道如下。, 百拇医药(郭家伟 王雨龙 王宁)
【关键词】 腹腔镜； 胆道镜； 高龄胆囊合并胆总管结石； 疗效
doi：10.14033/j.cnki.cfmr.2018.15.010 文献标识码 B 文章编号 1674-6805(2018)15-00-03
The Observation of Curative Effect of Aged Gallbladder Combine the Choledocholithiasis Treated by Laparoscope and Choledochoscope/GUO Jiawei，WANG Yulong，WANG Ning.//Chinese and Foreign Medical Research，2018，16(15)：-27
【Abstract】 Objective：To analyse the treatment effect of aged gallbladder combine the choledocholithiasis treated by laparoscope and choledochoscope.Method：From June 2015 to June 2017，60 cases of patients with aged gallbladder combine the choledocholithiasis in our hospital were selected and randomly divided into two groups，30 cases in each group.The control group used the regular operation for treatment，the treatment group used the laparoscope combine choledochoscope for treatment.Analysed and compared the surgical treatment of the two groups.Result：The blood loss volume during the operation，time of operation，hospital stays and evacuation time of the treatment group were better than those of the control group，the differences were statistically significant(t=8.294，5.383，13.498，9.144，P<0.05).The complication rate and recurrence rate in the observation group were lower than those in the control group，but the difference was not statistically significant(字2=3.750，1.456，P>0.05).Compared the pain degree of the two groups before and after surgery，there were no statistical significance(t=0.872，0.522，P>0.05).Conclusion：Laparoscopy combined with choledochoscopy in the treatment of old gallbladder combined with choledocholithiasis can reduce the trauma to the patients，the incidence of complications and the recurrence rate are not high，alleviate the pain of the patients.It is worth popularizing in clinical application.
【Key words】 Laparoscope； Choledochoscope； Aged gallbladder combine the choledocholithiasis； Curative effect
First-author’s address：Mianyang People’s Hospital，Mianyang 621000，China
膽囊合并胆总管结石是老年人多发病之一，随着我国老龄化人口的加剧，高龄胆囊合并胆总管结石在我国的发病率呈逐年上升的趋势，已成为严重的公共安全卫生问题。胆囊合并胆总管结石患者发病时疼痛难忍，严重时危及患者的生命[1]。由于患者大多为老年人群，自身机体功能减退，抵抗力较弱，对手术的耐受度下降，对于以往常规的开腹手术治疗承受力下降，导致容易出现术后并发症。随着医学技术的发展，临床上逐渐采用腹腔镜联合胆道镜治疗胆囊合并胆总管结石，因其具有创伤性小，患者预后快等特点，且在手术中不会对患者十二指肠乳头括约肌的功能造成破坏[2-3]。本研究对高龄胆囊合并胆总管结石患者采用腹腔镜和胆道镜治疗的临床效果进行分析，现总结报道如下。, 百拇医药(郭家伟 王雨龙 王宁)