腹腔镜联合胆道镜治疗肝外胆管结石的临床应用效果.pdf

2023NO.2中外医疗临床医学China&ForeignMedicalTreatmentDOI：10.16662/j.cnki.1674-0742.2023.02.059腹腔镜联合胆道镜治疗肝外胆管结石的临床应用效果董正升甘肃省天水市中医医院外二科，甘肃天水741000［摘要］目的探究腹腔镜联合胆道镜治疗肝外胆管结石的临床效果。方法随机选取甘肃省天水市中医医院2020年1月—2021年8月诊治的100例肝外胆管结石患者，随机分为A组（50例）、B组（50例），分别实施开腹手术治疗、腹腔镜联合胆道镜治疗。比较两组治疗效果、手术及康复相关指标、血清炎症反应水平、肾素-血管紧张素系统情况、并发症及1年复发率。结果B组治疗有效率与A组相比，差异无统计学意义（P>0.05）；B组术中出血量较A组少，术后镇痛时间、胃肠道功能恢复时间、腹腔引流管拔除时间、T管夹闭时间均较A组短，差异有统计学意义（P<0.05）；术前1d，B组TNF-α、IL-6、Ang1-7、AngⅠ、AngⅡ水平与A组相比，差异无统计学意义（P>0.05）；术后1d，B组TNF-α、IL-6、Ang1-7、AngⅠ、AngⅡ水平水平均较A组低，差异有统计学=4.396P<0.05B1意义（P<0.05）；B组并发症发生率为2.00%，较A组16.00%，差异有统计学意义（χ2，）；组年复发率为6.00%，与A组4.00%相比，差异无统计学意义（P>0.05）。结论对肝外胆管结石患者实施腹腔镜联合胆道镜手术，可缩短其术后康复时间、降低术后并发症发生率，降低其炎症因子水平及生理应激反应。［关键词］肝外胆管结石；腹腔镜；胆道镜［中图分类号］R657［文献标识码］A［文章编号］1674-0742（2023）01(b)-0059-05ClinicalEffectofLaparoscopyCombinedwithCholedochoscopyintheTreatmentofExtrahepaticBileDuctStonesDONGZhengshengSecondDepartmentofSurgery,TianshuiTraditionalChineseMedicineHospital,Tianshui,GansuProvince,741000China[Abstract]ObjectiveToinvestigatetheclinicaleffectsoflaparoscopycombinedwithcholangoscopyinthetreatmentofextrahepaticbileductstones.MethodsAtotalof100patientswithextrahepaticbileductstonesfromJanuary2020toAugust2021diagnosedandtreatedinTianshuiTraditionalChineseMedicineHospitalofGansuProvincewerese⁃lectedandrandomlydividedintogroupA(50cases)andgroupB(50cases),andopensurgeryandlaparoscopycom⁃binedwithcholangoscopywerecarriedout,respectively.Thetreatmenteffect,surgicalandrehabilitationrelatedindi⁃cators,seruminflammatoryresponselevel,renin-angiotensinsystem,complicationrateandone-yearrecurrencerateofthetwogroupswerecompared.ResultsTherewasnostatisticallysignificantdifferenceintheeffectiverateoftwogroupsA(P>0.05).ComparedwithGroupA,theintraoperativebloodlossinGroupBwasless,andthepostoperativeanalgesiatime,gastrointestinalfunctionrecoverytime,abdominaldrainagetuberemovaltime,andTtubeclampingtimewereshorterthanthoseofGroupA,andthedifferencewasstatisticallysignificant(P<0.05).therewasnostatisti⁃callysignificantdifferenceinth