腹腔镜保胆取石术对胆囊结石患者胃肠道功能恢复的影响
The Effect of Laparoscopic Min-cholecystolithotomy on the Gastrointestinal Function Recovery of Patients with Gallbladder Stone
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摘要: [摘要] 目的 探索腹腔镜下微创保胆取石术对胆囊结石患者的手术效果及术后胃肠道功能恢复的影响.方法 将2013年6月至2015年6月核工业四一六医院普外科收治的胆囊结石患者372例分为观察组(行腹腔镜微创保胆取石术)和对照组(行腹腔镜胆囊切除术),每组186例.比较2组患者手术时间、术中出血量、住院天数、饮食恢复时间、胃肠道功能恢复情况以及术后随访情况.结果 观察组术中出血量和术后饮食恢复时间均好于对照组(P<0.05);观察组术后肠鸣音恢复时间、肛门首次排气及排便时间均短于对照组,胃肠道不良反应发生率低于对照组,差异有统计学意义(P<0.05);术后随访,观察组术后腹胀腹泻等不良反应发生率为4.30%,显著低于对照组(17.20%),差异具有统计学意义(P<0.05).结论 腹腔镜下微创保胆取石术治疗胆囊结石具有术中出血量少、术后饮食恢复时间短、患者胃肠道恢复快,不良反应发生率低等优点,有较好的临床应用价值.Abstract: [Abstract]Objective To investigate the clinical effect of laparoscopic min-cholecystolithotomy on the gastrointestinal function recovery of patients with gallbladder stone. Methods 372 patients with gallbladder stone were enrolled in this study. 186 patients in observation group were treated by min-cholecystolithotomy,while 186 patients in control group were treated by laparoscopic cholecystectomy. The operation time,intraoperative bleeding volume,postoperative hospital stay, diet recovery time,gastrointestinal function and postoperative follow-up were compared. Results The intraoperative bleeding volume and diet recovery time in observation group were significantly less or shorter than those in control group(P<0.05);the time of intestinal sound recovery,first exhaust and defecation of observation group were significantly shorter than those of control group(P<0.05). The incidence of gastrointestinal adverse reactions in observation group was significantly reduced compared with control group (P<0.05). The incidence of abdominal distension,diarrhea,bile duct injury and choledocholithiasis was 4.30% in observation group,which was significantly lower than that in control group(P<0.05). Conclusions Laparoscopic min-cholecystolithotomy has such advantages as less blood loss,shorter diet recovery time, faster gastrointestinal function recovery and lower incidence of complications, and it has clinical application value.
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