内镜腹腔镜联合与腹腔镜下治疗胆囊并胆总管结石临床分析评价

目的 比较内镜腹腔镜联合与腹腔镜下治疗胆囊结石合并胆总管结石的临床疗效.方法 76例胆囊结石合并胆总管结石患者按随机数字表法分为观察组和对照组,每组38例,分别采用腹腔镜下胆囊切除术(LC)+内镜下括约肌切开术(EST)和LC+胆总管切开取石+T管引流术(LCTD),对比观察两组的手术时间、住院时间、术中出血量和并发症情况.结果 观察组手术时间和住院时间分别为(105.3±13.2)min和(11.3±3.2)d,均显著短于对照组[分别为(140.5±15.6)min、(14.2±4.6)d],差异有统计学意义(P<0.05).两组均未发生严重并发症.结论 LC+EST治疗胆囊结石合并胆总管结石疗效肯定、创伤小、术后恢复快且并发症少,值得临床推广应用.

Abstract：

Objectivc To compare the clinical effieacy of laparoscopic cholecystectomy(LC) combined with endoscopic sphincterotomy (EST) and LC in treatment of cholecystolithiasis associated with choledocholithiasls.Methods Seventy-six patients with cholecystolithiasis associated with choledocholithiasis were divided into observation group and control group by random digits table,38 cases in each group,and respectively received LC combined with EST and LC combined with choledocholithotomy and T drainage.Theoperative time,hospitalization time,blood loss and complications in the two groups were compared.Results The operative time and hospitalization time of observation group were(105.3±13.2)min and(11.3±3.2)d respectively,and which were significantly shorter than those in control group[(140.5±15.6)min,(14.2±4.6)d],the differences were statistically significant between the two groups(P<0.05).Both groups had no serious complications happened.Conclusion LC combined with EST in treatment of cholecystolithiasis associated with choledocholithiasis has advantages such as effective,litfle trauma,rapid recovecy and less comphcations,it is worthy of clinical application.     

经脐单孔腹腔镜及常规腹腔镜阑尾切除术治疗阑尾炎的临床效果比较

目的 探讨经脐单孔腹腔镜阑尾切除术、常规腹腔镜阑尾切除术应用于阑尾炎的临床效果.方法 选取本院2018年12月至2019年9月收治的80例阑尾炎患者,根据治疗方法的不同分为对照组和观察组,每组40例.对照组行常规三孔腹腔镜阑尾切除术治疗,观察组行经脐单孔腹腔镜阑尾切除术治疗.比较两组围术期指标、中转开腹发生率及并发症发生率.结果 观察组术中出血量少于对照组,手术切口长度、术后首次下床活动时间均短于对照组,差异有统计学意义(P<0.05);两组手术时间、术后肛门首次排气时间、术后引流时间、术后住院时间比较差异无统计学意义;术后住院期间及出院后6个月,两组并发症发生率比较差异无统计学意义.结论 经脐单孔腹腔镜阑尾切除术、常规三孔腹腔镜阑尾炎切除术均具有良好近、远期预后,但前者更利于患者腹部的美观和术后康复,值得临床推广应用.