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腹壁悬吊替代气腹经腹腔镜胆囊切除术和与常规气腹经腹腔镜胆囊切除术比较
基金项目:浙江省科学技术成果(13006205);浙江省诸暨市科学技术奖(2013039)
摘    要:目的 探讨腹壁悬吊替代气腹经腹腔镜胆囊切除术与常规气腹经腹腔镜胆囊切除术临床效果。方法 选取2015 年2 月~2018 年1 月我院收治的84 例胆囊炎患者,按照随机数表法分为对照组和研究组,各42 例,对照组采取常规气腹经腹腔镜胆囊切除术,研究组采取腹壁悬吊下腹腔镜胆囊切除术。分析对比两组患者术后治疗有效率、手术结果和并发症发生率。结果 术后研究组治疗有效率显著高于对照组(P<0.05);研究组术中出血量、手术时间、术后肛门排气时间均显著低于对照组(P<0.05);研究组恶心呕吐、肩部疼痛、皮下水肿、感染等术后并发症发生率显著低于对照组(P<0.05)。结论 腹壁悬吊替代气腹经腹腔镜胆囊切除术治疗胆囊炎可显著提高治疗有效率,降低术中出血量、手术时间、术后并发症发生率,安全性更高,值得临床上进一步推广应用。

关 键 词:腹壁悬吊下经腹腔镜胆囊切除术  常规气腹经腹腔镜胆囊切除术  手术结果  并发症发生率

Comparison of laparoscopic cholecystectomy and conventional pneumoperitoneum cholecystectomy with abdominal wall suspension instead of pneumoperitoneum
Abstract:Objective To investigate the clinical effects of laparoscopic cholecystectomy and conventional pneumoperitoneum cholecystectomy with abdominal wall suspension instead of pneumoperitoneum. Methods Eighty-four cholecystitis patients admitted to our hospital from February 2015 to January 2018 were selected and divided into a control group and a study group according to the random number table method. 42 patients in the control group underwent conventional laparoscopic cholecystectomy. For resection, the study group underwent laparoscopic cholecystectomy under abdominal wall suspension. The postoperative therapeutic efficacy, surgical outcomes and complication rates were analyzed and compared between the two groups. Results The effective rate of treatment in the study group was significantly higher than that of the control group(P<0.05). The amount of intraoperative blood loss, operation time, and postoperative anus exhaust time were significantly lower in the study group than in the control group (P<0.05); The incidence of postoperative complications such as nausea and vomiting, shoulder pain, subcutaneous edema and infection was significantly lower than that in the control group (P<0.05). Conclusion Abdominal wall suspension instead of pneumoperitoneum for laparoscopic cholecystectomy for cholecystitis can significantly increase the efficiency of treatment, reduce intraoperative blood loss, operation time, incidence of postoperative complications and has higher safety. It is worthy of further promotion in clinical application.
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