传统开放术式与腔镜联合术式治疗老年胆囊结石合并胆总管结石的临床对比研究

Combination of open and laparoscopic surgery in treatment of elderly patients with gallbladder stones combined with common bile duct stones

摘要:

目的 探讨传统开放术式与腔镜联合术式治疗老年胆囊结石合并胆总管结石临床效果及安全性差异。方法 研究对象选取该院2013年1月-2015年6月收治老年胆囊结石合并胆总管结石患者共130例，以随机区组法分别分为对照组（65例）和观察组（65例），分别采用传统开放术式和腔镜联合术式治疗；比较两组患者围手术期临床指标水平、结石完全清除率，术后镇痛药物使用率及并发症发生率等。结果 观察组患者手术时间、术中出血量、术后首次排气时间及住院时间均明显优于对照组，差异有统计学意义（P <0.05）；两组患者结石完全清除率比较差异无统计学意义（P >0.05）；观察组患者术后镇痛药物使用率明显低于对照组，差异有统计学意义（P <0.05）；观察组患者术后切口感染、肺部感染及胆漏发生率均明显低于对照组，差异有统计学意义（P <0.05）。结论 腔镜联合术式治疗老年胆囊结石合并胆总管结石可有效缩短手术时间，加快术后康复进程，减轻术中创伤和术后疼痛程度，并有助于预防术后并发症发生，临床价值优于传统开放术式。

Abstract:

Objective To investigate the clinical effects and safety of combination of open and laparoscopic surgery in treatment of elderly patients with gallbladder stones combined with common bile duct stones. Methods 140 elderly patients with gallbladder stones combined with common bile duct stones from May 2014 to May 2015 were randomly divided into control group (65 patients) with traditional open surgery and observation group (65 patients) with combination surgery; then compared the perioperative clinical indicators, the total removal rate of stone, the postoperative analgesic used rate and postoperative complications incidence of the two groups. Results The operation time, intraoperative blood loss volume, the exhaust time for first time and hospital staying time of observation group was significantly better than control group (P < 0.05). There was no significant difference in the total removal rate of stone between the two groups (P > 0.05). The postoperative analgesic used rate of observation group was significantly lower than control group (P < 0.05). The postoperative complications incidence of observation group was significantly lower than control group (P < 0.05). Conclusion Compared with traditional open surgery, combination surgery in treatment of elderly patients with gallbladder stones combined with common bile duct stones can efficiently shorten the operation time, speed up the recovery process, reduce the degree of trauma and postoperative pain and helpful to prevent the postoperative complications.