基层医院腹腔镜联合胆管镜行胆总管探查一期缝合的临床应用.doc

《基层医院腹腔镜联合胆管镜行胆总管探查一期缝合的临床应用.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、基层医院腹腔镜联合胆管镜行胆总管探查一期缝合的临床应用［摘耍］目的探讨腹腔镜联合胆管镜用于临床胆总管探查术后一期缝合的可行性。方法对本院2011年5月〜2014年6月就诊的的80例患者进行临床研究，随机分为治疗组与对照组，治疗组患者接受腹腔镜胆总管探查并一期缝合，对照组患者接受传统治疗并一期缝合，观察比较两组患者的临床疗效。结果治疗组平均手术时间较对照组短,差异有统计学意义(卩〈0.05)；治疗组平均术中出血量较对照组少，差异有统计学意义(P<0.05)；治疗组平均住院时间(6.5±4.0)d,明显短于对照组(P〈0・05)；治疗组发生胆漏所占比例为5%,对照组服

2、漏所占比例为10%,差异有统计学意义(1X0.05)；治疗组平均术后恢复至排气时间较对照组短，差异有统计学意义(P〈0.05)。结论腹腔镜联合胆管镜治疗胆总管结石一期缝合术在严格选择病例前提下，是安全可行的，值得基层医院推广。［关键词］腹腔镜；胆管镜；胆囊结石；慢性胆囊炎［中图分类号］R657.4［文献标识码］A［文章编号］1674-4721(2015)06(a)-0024-03ClinicalapplicationoflaparoscopiccombinedcholedochoscopyforprimarysutureofbileductexplorationL

3、IFa-wenTAOXu-xiongDepartmentoftheFirstSurgery,ZijinCounty卩eople'sHospitalofHeyuanCityinGuangdongProvince,Zijin517400,China[Abstract]ObjectiveToinvestigatethefeasibilityoftheprimaryclosureofcommonbileductaftertheexplorationbythecombinationoflaparoscopicandcholedochal.Methods80patientsw

4、howerecuredinourhospitalfromMay2011toJune2014werechoosenasourresearchproject,andrandomlydividedintotreatmentgroupandcontrolgroup,treatmentgroupwasreceivedtheprimaryclosureofcommonbileductaftertheexplorationofthecombinationoflaparoscopicandcholedochal.Controlgroupwereconductedbytraditi

5、onaltreatmentandsuture・Clinicaleffectbetweentwogroupswascompared.ResultsTheaverageoperationtimeintreatment.groupwassignificantlyshortenedthanthatincontrolgroup,withstatisticaldifference(P<0.05)；Theaverageamountofbleedinginoperationoftreatmentgroupwaslessthanthatincontrolgroup,withstat

6、isticaldifference(P<0.05)；Theaveragehospitalizationtimeoftreatment.groupwasdecreasedcomparedwithcontrolgroup(P<0.05)；Bileleakageaccountedfor5%intreatmentgroup,whilebileleakagewas10%incontrolgroup,withstatisticaldifference(卩〈0.05)；Theaveragepost-operativeoftreatmentgroupaftertherestora

7、tionwasshorterthanincontrolgroup,withstatisticaldifference(P<0.05).ConclusionLaparoscopiccombinedwithbileduetendoscopyinthetreatmentofcommonbileductstones,astagesutureinthestrictchoiceofcase,issafeandfeasible,itisworthyofthepromotionprimaryhospital.[Keywords]Laparoscopic；Choledochosco

8、py；Ga