腹腔镜联合胆道镜治疗老年胆道结石的研究.docVIP

腹腔镜联合胆道镜治疗老年胆道结石的研究 　　[摘要] 目的 探讨应用腹腔镜治疗胆结石症的手术技巧及临床疗效。方法 整群选择2013年5月―2015年5月期间该院收治的62例老年胆结石症患者作为受试者，随机分为对照组和观察组，各31例。对照组患者按照病情行常规开腹术式治疗，观察组患者均采用腹腔镜联合胆道镜治疗，比较两组患者结石清除率、手术时间、术中出血量、术后复发率等指标，评价两组治疗效果。结果 观察组在手术时间、 术中出血量、 住院时间、术后复发率指标数值方面，显著低于对照组，组间差异有统计学意义（P0.05）。在结石清除率方面，观察组（87.10%）显著低于对照组（70.97%），组间差异有统计学意义（P0.05）。观察组术后并发症率（3.23%）显著低于对照组（19.35%），组间差异有统计学意义（P0.05）。 结论 胆结石症患者应用腹腔镜联合胆道镜治疗，有助于提高结石清除率，并减少术中出血量、术后并发症，术后复发率、手术及住院时间等，应在胆结石症治疗推广使用腹腔镜。 　　[关键词] 老年患者；胆结石；胆道镜；腹腔镜 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-0742（2015）12（c）-0025-03 　　Study on the Treatment of Elderly Patients with Biliary Calculi by Laparoscopy Combined with Choledochoscopy 　　FU Zhi-chun 　　Department of General Surgery， TCM Hospital of Funing County， Funing， Jiangsu Province， 224400 China 　　[Abstract] Objective To investigate the surgical techniques and clinical effects of laparoscopic treatment of gallstones. Methods 62 elderly patients with gallstones admitted in our hospital during May 2013 to May 2015 were selected as the subjects and randomly divided into the control group and the observation group， 31 cases in each group. The control group were treated with conventional open operation in accordance with their conditions， the observation group were treated by cholecystectomy with laparoscope and choledochoscope. And the stone removal rate， duration of operation， intraoperative blood loss， and postoperative recurrence rate and other indicators of the two groups were compared. And the treatment effects of the two groups were evaluated. Results Compared with the control group， the observation group had much shorter duration of procedure， obviously less intraoperative blood loss， much shorter length of stay and significantly lower postoperative recurrence rate， the differences between the groups were statistically significant， P 　　[Key words] Elderly patients； Gallstones； Choledochoscope； Laparoscope 　　胆结石症是常见的胆道系统结石疾病，其发病机制较为复杂，目前已知胆汁中的胆色素、胆固醇等因素与结石形成密切相关[1]。胆结石症主要临床表现为，右上腹剧烈疼痛、黄疸、高热、恶心呕吐等，需要及