| 黄捷,李宁,吴可人,徐涛,金法,阎九亮.腹腔镜保胆取石手术中黏膜反转法的临床疗效分析[J].浙江中西医结合杂志,2018,28(2): |
| 腹腔镜保胆取石手术中黏膜反转法的临床疗效分析 |
| Efficacy of gallbladder mucosa reversal method in laparoscopic cholecystolithotomy |
| 投稿时间：2017-04-17 修订日期：2017-12-30 |
| DOI： |
| 中文关键词: 保胆取石,黏膜反转法,胆囊收缩功能 |
| 英文关键词:cholecystolithotomy mucosa reversal method gallbladder contractile function |
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| 中文摘要: |
| 目的 比较黏膜反转法腹腔镜保胆取石术和常规腹腔镜保胆取石术的临床疗效和术后胆囊收缩功能情况。方法 选择2013年1月至2016年6月间收治的63例胆结石患者为研究对象,其中24例患者采用黏膜反转法腹腔镜保胆取石术进行治疗(观察组),另外39例患者行常规腹腔镜保胆取石术进行治疗(对照组),观察两组患者治疗效果和手术前后胆囊收缩功能的变化。使用SPSS19.0对数据进行计算与统计,治疗前后的胆囊功能的空腹胆囊容积、最小剩余容积、最大收缩率和治疗结果的手术时间、出血量、术后住院时间用均数±标准差表示,采用t 检验,两组患者的疗效数据采用秩和检验,当 P<0.05时差异有统计学意义。结果 观察组术后6月胆囊功能均恢复正常,但胆囊收缩率较术前有所下降,差异有统计学意义(t=2.534,P<0.05)。对照组术后6月胆囊收缩率基本恢复术前水平。两组患者胆囊收缩功能无统计学差异(P>0.05)。在两组患者手术时间、出血量和术后住院时间的比较上,观察组在手术时间上明显优于对照组,差异有统计学意义(t =3.651 , P<0. 05 )。通过随访记录显示,两组患者的疗效差异不大,疗效比较上无统计学意义(P>0.05)。结论 黏膜反转法腹腔镜保胆取石术安全可行,具有创伤小,术中出血少,术后恢复快等优点,显著缩短手术时间,术后结石复发率低,对胆囊收缩功能无显著影响,值得进一步推广。 |
| 英文摘要: |
| Objective: To compare the clinical efficacy and the postoperative gallbladder contractile function of laparoscopic cholecystolithotomy with gallbladder mucosa reversal method and normal laparoscopic cholecystolithotomy. Methods: A total of 63 patients with gallstones who had received operation from January 2011 to June 2014 in our hospital were enrolled in this study. The patients were divided into two groups:a treatment group and a control group. The treatment group consisted of 24 patients who received laparoscopic cholecystolithotomy with gallbladder mucosa reversal method, whereas the control group comprised 39 patients who had received normal laparoscopic cholecystolithotomy for gallstones. We observed the gallbladder contractile function of the two groups before and after surgery, and compared the results after operation. SPSS 19.0 was used for statistical analysis. The operative time, blood loss, postoperative hospitalization, fasting gallbladder volume, minimum residual volume, maximum shrinkage were expressed as mean + SD and examined by t-test. The efficacy of the two groups was examined by the rank-sum test. P<0.05 was considered as statistically significant. Results: The shrinkage rate of gallbladder was reduced significally 6 months after operation in the treatment group（t=2.534, P<0.05）,while it was almost recovered to the preoperative level in both group. Meanwhile, there was no difference in gallbladder contractile function between the two groups. Operative time were significantly better in the treatment group than in the control group(t=3.651, P<0.05). There was little difference in blood loss, postoperative hospitalization and outcomes between the two groups(P>0.05). Conclusion: Laparoscopic cholecystolithotomy with gallbladder mucosa reversal method is safe and effective, with less traume, less bleeding, low recurrence and other advantages, even shorten the operative time. Meanwhile, there was no significant effects on the?contractile?function of gallbladder, so it is worthy of further promotion. |
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