免气腹经脐单孔腹腔镜在胆囊切除术应用中的临床价值分析

目的分析免气腹经脐单孔腹腔镜在胆囊切除术应用中的临床价值。方法选取2011年3月至2013年9月在东莞常安医院进行治疗的胆囊良性疾病患者64例,根据患者个人意愿选择两种不同治疗方案,即免气腹经脐单孔腹腔镜组(n=32例)及传统腹腔镜组(n=32),对比观察两组患者的术中及术后相关指标和并发症。结果两组患者手术中的操作时间和手术中的出血量无统计学意义(P>0.05),单孔腹腔镜组的心率和平均动脉压均显著低于传统腹腔镜组(74.4±8.4)次/min vs(81.0±10.9)次/min,(94.7±6.5)mm Hg vs(98.9±6.4)mm Hg,(P<0.05)];单孔腹腔镜组的术后首次下床活动时间、术后出现排气时间及术后的平均住院日均显著低于传统腹腔镜组患者(9.6±4.4)h vs(12.7±5.4)h,(20.9±3.8)min vs(24.2±4.8)min,(4.1±1.4)d vs(4.9±1.2)d,(P<0.05)];单孔腹腔镜组的术后并发症的发生率显著低于传统腹腔镜组(6.25%vs 25.00%)(P<0.05)。结论免气腹经脐单孔腹腔镜能够安全、有效地应用于胆囊切除。

The Clinical Value of Gasless Transumbilical Single Incision Laparoscopy in Cholecystectomy

Objective To analyze the clinical value of transumbilical single incision laparoscopy in cholecystectomy. Methods A total of 64 cases of patients with benign gallbladder disease in Dongguan Chang＇an Hospital from Mar. 2011 to Sep. 2013 were included. According to patients individual wishes, they were divided into tran- sumbilical gasless laparoscopy group （n = 32 ） and conventional laparoscopic group （n = 32）, and intraoperative and postoperative related indicators and complications of the two groups were observed and compared. Results Surgical operating time and blood loss had no significant differences （ P 〉 0.05 ）. HR and mean arterial pressure of single-port laparoscopic surgery group were significantly lower than conventional laparoscopic group （74.4 ± 8.4 ） beats/min vs （81.0 ± 10.9） beats/min,（94.7±6.5） mm Hg vs （98.9 ±6.4） mm Hg （P 〈0.05） ] ;the first postoperative ambulation time, postoperative exhaust time and the postoperative average length of hospital stay of single-incisian laparoscopic surgery group were significantly lower than traditional laparoscopic group （9.6 ± 4.4） h vs （12.7 ±5.4） h,（20.9 ±3.8） rain vs （24.2 ±4.8） min,（4.1 ± 1.4） d vs （4.9 ± 1.2） d （P 〈0.05） ] ; the incidence of postoperative complications of single-incision laparoscopic surgery group was significantly lower than conventional laparoscopic group （6.25 % vs 25.00% ） （ P 〈 0.05 ）. Conclusion Transumbilical single incision laparoscopic cholecystectomy com be effectively and safely applied in cholecystectomy.