自制改良标本袋在腹腔镜胆囊切除术中的临床应用

目的自制改良标本袋在腹腔镜胆囊切除术(LC)中经脐取出胆囊的优点和可行性探讨。方法选取我院普外科2018年1至12月LC的58例患者作为研究对象,分经脐取胆囊组30例(改良组)和经剑突下取胆囊组28例(常规组),记录两组患者的基础资料(性别、年龄、体指数、ASA评分)、手术适应症;比较两组患者中转开腹率及并发症发生率、平均手术时间、术中费用及总费用、术后疼痛持续时间及数字疼痛程度评分(NRS)、术后住院时间。结果两组患者基础资料无统计学差异,所有病例无中转开腹及严重并发症发生,两组患者平均手术时间,总住院治疗费用及术后住院时间均无统计学差异(P0.05),但术后住院时间改良组较常规组有所下降,改良组术后疼痛缓解时间明显缩短,疼痛程度评分明显下降(P0.05)。结论利用自制改良标本取出袋可以方便的从脐部切口取出胆囊,减轻剑突下戳卡损伤,避免缝合,缩短术后住院时间及治疗费用,明显缩短切口疼痛时间及疼痛强度,同时可以避免结石或胆汁掉入腹腔或污染伤口,符合外科快速康复理念。

Clinical Application of Self-made Modified Specimen Bag in Laparoscopic Cholecystectomy

［Abstract］ Objective To explore the advantages and feasibility of Self-made Modified Specimen Bag in laparoscopic cholecystectomy （LC）. Methods Fifty-eight patients undergoing LC in general surgery from January 2018 to December 2018 were selected as the research objects, and randomly divided into the umbilical cholecyst extraction group （30 cases in the improved group） and the xiphoid cyst extraction group （28 cases in the conventional group）. Basic data （Gender, Age, Body mass index, ASA score） and surgical indications of the two groups were recorded. The patients in the two groups were compared in terms of the conversion rate of laparotomy, incidence of complications, average operation time, intraoperative cost and total cost, postoperative pain duration and pain degree score（NRS）, and postoperative hospitalization time. Results Basic data no statistical difference in both groups, all cases with no transfer laparotomy and severe complications occurred, two groups of patients with an average operation time, total cost of hospitalization and postoperative hospital stay were no statistical difference （P>0.05）, but the length of hospital stay in the improved group was lower, postoperative pain relief time improved group was obviously shortened, the degree of pain scores significantly decreased （P<0.05）. Conclusion The self-made modified specimen removal bag can be used to conveniently remove the gallbladder through the umbilical incision, reduce the damage caused by stabbing the subcoastal incision, avoid suture, shorten the postoperative hospitalization time and cost of treatment, significantly shorter incision pain and pain intensity, and prevent calculus or bile from falling into the abdominal cavity or polluting the wound, fully conforms to the concept of enhanced recovery after surgery.