胆囊阑尾联合微创外科治疗方案研究

Minimally invasive combination resection of gallbladder and appendix

摘要:

目的  探讨脐周三孔与单孔两种腔镜微创手术方案行胆囊阑尾微创联合切除临床疗效差异。 方法  研究对象选取该院近年来收治需行胆囊阑尾联合切除患者共80例，采用随机数字表法分为A组（40例）和B组（40例），分别采用经脐周三孔和单孔腹腔镜术式治疗；比较两组患者围手术期临床指标、手术整体满意度、手术前后抑郁焦虑视觉模拟评分及术后并发症发生率等。结果  两组患者手术时间、术中出血量、术后肛门排气时间、术后6 h视觉模拟评分及住院时间比较差异无统计学意义（P >0.05）；B组患者手术切口长度明显短于A组，差异有统计学意义（P <0.05）；B组患者手术整体满意度评分明显优于A组，差异有统计学意义（P < 0.05）；B组患者术后抑郁焦虑视觉模拟评分均明显优于A组及治疗前，差异有统计学意义（P <0.05）；两组患者术后并发症发生率比较差异无统计学意义（P >0.05）。结论  相较于脐周三孔术式，脐周单孔腹腔镜术式行胆囊阑尾微创联合切除可有效减少术后切口瘢痕，提高患者满意程度，改善抑郁焦虑情绪，且未增加术后并发症发生风险。

Abstract:

 【Objective】 To investigate the clinical effects of three holes and single-port minimally invasive laparoscopic operation scheme for minimally invasive combination resection of gallbladder and appendix. 【Methods】 80 patients with combination resection of gallbladder and appendix were chosen in recent years in our hospital and randomly divided into both group including A group (40 patients) with cullen three holes laparoscopic operation and B group (40 patients) with single-port laparoscopic operation; and the clinical indicators in peri-operation period, the operation overall satisfaction, the visual analogue scale of anxiety and depression before and after operation and the incidence of postoperative complications of both groups were compared. 【Results】 There was no significant difference in operation time, bleeding volume, postoperative anal exhaust time, the visual analog score in 6h after operation and hospitalization time between 2 groups (P < 0.05). The incision length of B group was significantly shorter than A group (P < 0.05). The operation overall satisfaction of B group was significantly better than A group (P < 0.05). The visual analogue scale of anxiety and depression after operation of B group was significantly better than A group and before operation (P < 0.05). There was no significant difference in incidence of postoperative complications between 2 groups (P < 0.05). 【Conclusion】 Compared with cullen three holes laparoscopic operation, single-port laparoscopic operation for minimally invasive combination resection of gallbladder and appendix can efficiently reduce incision scar degree, higher patient satisfaction, relieve depression and anxiety, and not increase the risk of postoperative complications.