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《腹腔鏡聯(lián)合膽道鏡在肝內(nèi)外膽道結(jié)石治療中的應(yīng)用.pdf》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、齊齊哈爾醫(yī)學(xué)院學(xué)報(bào)2014年第35卷第5期JournalofOiqihnrUniversityofMedicine，2014，Vo1．35，No．5·639·．論著．腹腔鏡聯(lián)合膽道鏡在肝內(nèi)外膽道結(jié)石治療中的應(yīng)用許沈南李曉輝盧旭生張偉亮黃麗君李佳杰【摘要】目的探討對(duì)肝內(nèi)外膽道結(jié)石患者采用腹腔鏡聯(lián)合膽道鏡治療的效果及安全性。方法選擇2010年5月至2013年5月我院收治的80例肝內(nèi)外膽道結(jié)石患者作為臨床觀察對(duì)象。按照患者的意愿分為治療組(4O例)與對(duì)照組(40例)。治療組給予腹腔鏡與膽道鏡聯(lián)合治療，對(duì)照
2、組給予常規(guī)的開(kāi)腹手術(shù)治療。主要觀察兩組患者手術(shù)時(shí)間、手術(shù)出血量、術(shù)后下床活動(dòng)時(shí)間、術(shù)后并發(fā)癥率及住院天數(shù)等治療指標(biāo)。結(jié)果治療組在手術(shù)時(shí)間、術(shù)后下床活動(dòng)時(shí)間及住院天數(shù)方面，用時(shí)均顯著短于對(duì)照組(P<0．O5)；治療組手術(shù)出血量也比對(duì)照組少，兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0．05)；治療組術(shù)后出現(xiàn)膽道出血2例，膽源性胰腺炎1例，感染1例，總并發(fā)癥率為10％，對(duì)照組出現(xiàn)膽漏2例，膽道出血5例，膽源性胰腺炎2例，感染3例，總并發(fā)癥率是30％，兩組并發(fā)癥率比較差異顯著(P<0．05)。結(jié)論采用腹腔鏡聯(lián)合膽道
3、鏡實(shí)施肝內(nèi)外膽道結(jié)石手術(shù)，具有比開(kāi)腹手術(shù)創(chuàng)傷小、術(shù)中出血量少、術(shù)后并發(fā)癥少等優(yōu)勢(shì)，安全有效，療效確切，此法值得臨床推廣應(yīng)用?！娟P(guān)鍵詞】腹腔鏡；膽道鏡；肝內(nèi)外膽管結(jié)石；效果ApplicationoflaparoscopecombinedwithcholedochoscopeinthetreatmentofbiliarycaiculiXUShen—nan，eta1．Departmentofsurgeryinpeople'sHospital，Puning，Guangdong，515300，China【Ab
4、stract】ObjectiveToinvestigatetheapplicationefficacyoflaparoscopecombinedwithcholedochoscopeinthetreatmentofinternal／externalbiliarycalculiandit'ssafety．MethodsTotally80casesofpatientssuferedfrominternal／extemalbiliarycalculiwereincludedinthisstudy，andt
5、heyweredividedintotreatmentgroup(n=40)andcontrolgroup(n=40)accordingtotheirownwil1．Patientsintreatmentgroupreceivedtherapyunderlaparoscopeandcholedochoscope，whilepatientsincontrolgroupreceivedconventionalsurgicaltherapy．Recordtheoperationtime，amountofb
6、leeding，postoperativeambulationtime，postoperativecomplicationrateandhospitalizetime．ResultsOperativetime，postoperativeambulationtimeandhospitalizetimeofthetreatmentgroupweresignificantlyshorterthanthecontrolgroup，andtheamountofbleedingoftreatmentgroupw
7、aslessthanthecontrolgroup(P<0．05)．Thetotalcomplicationrateintreatmentgroupwas10％(including2casesofbiliarytractbleeding．onecaseofbiliarypancreatitisandonecaseofinfection)，andthetotalcomplicationrateincontrolgroupwas30％(including5casesofbiliarytractbleed
8、ing．2caseofbiliarypancreatitisand3caseofinfection)，complicationratebetweenthetwogroupssignificantlydiferent(P<0．05)．ConclusionsLaparoscopecombinedwithcholedochoscopewasefectiveandsafeinthetreatmentofbiliarycalculiforithadtheadvantagessu
