腹腔镜联合胆管镜、钬激光治疗肝内外胆管结石的临床探讨.pdf

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1、·医护论坛中国当代医药2014年3月第21卷第9期腹腔镜联合胆管镜、钬激光治疗肝内外胆管结石的临床探讨殷耀华刘国生蔺晖琦尹照成黄眷杰广东省东莞市清溪医院普外科，广东东莞523660[摘要】目的探讨腹腔镜联合胆管镜、钬激光治疗肝内外胆管结石的临床效果。方法回顾性分析本院收治的50例肝内外胆管结石患者，根据手术方式将所有患者分为实验组和对照组各25例，对照组行传统开腹手术，实验组采用腹腔镜联合胆管镜、钬激光手术，比较两组患者的临床治疗效果。结果对照组患者术中平均出血量为(310~50)ml，术后排气

2、时间为(45~5)h，住院时间为(12~2)d，术后出现切口感染3例，肠粘连2例，术后行“T”管造影发现胆管残留结石4例；实验组患者术中平均出血量为(90~15)ml，术后排气时间为(23~4)h，住院时间为(8±1．5)d，术后胆管残留结石l例。两组间比较，差异有统计学意义(P

3、(c)"0162—02Clinicalstudyoflaparoscopecombinedwithch0led0ch0sc0pe，holmiumlaserinthetreatmentofintrahepaticandextrahepaticbileductstonesYlNYao-huaLIUGuo-shengLINHui—qtYINZhao—chengHUANGJuan-fieDepartmentofGeneralSurgery，QingxiHospitalofDongguanCityinGu

4、angdongProvince，Dongguan523660，China【Abstract】ObjectiveToinvestigatetheclinicaleffectoflaparoscopycombinedwithcho1ed0choscopyandholmiumlaserinthetreatmentofintrahepaticandextrahepaticbileductstones．Methods50easesofhepatolithiasispatientsadmittedtoour

5、hospitalwereanalyzedretrospectively，andtheyweredividedintoexperimentalgroup(25cases)andcontrolgroup(25cases)accordingtotheoperationmode，controlgroupreceivedtraditionalopenoperation，theexpefi—mentalgroupusedlaparoscopecombinedwithcholedochoscope，holmi

6、umlaseroperation，theclinicaltreatmenteffectswascomparedbetweenthetwogroups．ResultsThehemorrhageduringoperationincontrolgroupwas(310~50)ml，theanusexhausttimeafteroperationwas(45_+5)h，thehospitalizationtimewas(12~2)d，postoperativeincisioninfectionwere3

7、caseandintestinaladhesionwere2cases，postoperative”T”tubewasfoundin4casesofbiliaryresidualstones．Thehemorrhageduringoperationinexperimentalgroupwas(310_+50)ml，theanusexhausttimeafteroperationwas(23~4)h，thehospitalizationtimewas(8~1．5)d，onecaseofpostop

8、erativeresidualbiliarytractstones．Comparedwiththetwogroups，thedifferencesoftwogroupswereallstatisticallysignificant(P