腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的围手术期护理

目的：探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床疗效及护理特点。方法：本院2010年7月-2013年6月外科收治的胆囊结石合并胆总管结石患者65例。分别实施开腹胆囊切除＋胆总管探查＋T管引流术及腹腔镜下胆囊切除＋胆总管探查术,其中开腹组31例,腹腔镜组34例。结果：两组患者术后胃肠功能恢复时间、进食时间、住院时间、护理满意度比较差异有统计学意义（P〈0.05）,手术中出血量、术后并发症发生率两组比较差异无统计学意义（P〉0.05）。结论：腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石具有创伤小、安全,疗效确切,护理人员通过精心护理,提高护理工作效率和质量,能达到更好的护理疗效。

Perioperative Nurse of Cholecystolithiasis Complicated with Choledocholithiasis Treatment by Laparoscopy together with Choledochoscopy

Objective：To investigate the value of clinical use and nursing methods of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis complicated with choledocholithiasis.Method：Of 65 patients suffering from cholecystolithiasis combined with choledocholithiasis in our hospital from July 2010 to June 2013.56 patients underwent laparoscopic cholecystectomy together with choledoeholithotomy and T-tube drainage（LC＋LCBDE）,and 31 patients received routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy.Result：Postoperative gastrointestinal function recovery time, dieting time, hospital stay and the patient＇s satisfaction with nursing care of the laparoscope group was significantly lower than those of the open group（P〈0.05）.There was not statistically significant between two groups in the blood loss and the incidence of complication.Conclusion：Laparoscopic cholecystectomy together with choledocholithotomy and T-tube drainage,has the advantages of minimal invasion,safety,quick recovery and short hospital stay with effective outcomes.Through careful nursing care, care workers improve nursing efficiency and quality,can achieve better nursing curative effect.