摘要
目的:探讨腹腔镜解剖性肝叶切除术治疗肝内胆管结石(IBDS)的疗效及安全性。方法:选取2017年9月至2019年9月IBDS患者160例,依据随机数字表法分为观察组和对照组,每组80例,观察组患者给予腹腔镜解剖性肝叶切除术治疗,对照组患者给予腹腔镜非解剖性肝叶切除术治疗,比较两组患者手术、创伤应激反应[肾上腺素(E)、皮质醇(COR)、C反应蛋白(CRP)]、并发症和复发情况。结果:观察组患者手术时间明显长于对照组患者,术中出血量、肝功能恢复、下床和住院时间明显低于对照组(P<0.05);两组患者术后E、COR、CRP水平明显高于术前,观察组患者术后E、COR、CRP水平明显低于对照组患者(P<0.05);观察组患者并发症发生率与复发率明显低于对照组患者(P<0.05)。结论:腹腔镜解剖性肝叶切除术可有效减轻IBDS患者手术创伤及并发症,有利于患者康复,且减少复发,具有较高的疗效及安全性,值得临床推广。
Objective:To discuss the efficacy and safety of laparoscopic anatomicalal lobectomy in the treatment of intrahepatic bile duct stones(IBDS).Methods:A total of 160 IBDs patients in our hospital were selected from September 2017 to September 2019,they were divided into the observation group and the control group according to the random number table,80 in each group.The observation group was treated with laparoscopic anatomicalal hepatectomy,the non observation group was treated with laparoscopic non anatomicalal hepatectomy,the operation,traumatic stress response[(adrenaline(E),cortisol(COR),C-reactive protein(CRP)],complications and recurrence were compared between the two groups.Results:The operation time in the anatomical group was significantly longer than that in the control group,and the intraoperative bleeding volume and the time of liver function recovery,getting out of bed and hospitalization in the anatomical group were significantly lower than that of the control group,the difference was statistically significant(P<0.05).The E,COR and CRP in the anatomical group and the control group after operation were significantly higher than those in the before operation,the E,COR and CRP in the anatomical group after operation were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of complications in the anatomical group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The recurrence rate in the anatomical group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic anatomical hepatectomy can effectively reduce the surgical trauma and complications of patients with IBDS,it is helpful to the physical recovery of patients,and it can reduce the recurrence,it has the higher efficacy and safety,it′s worth for further clinical promotion.
作者
薛思军
涂霁韬
XUE Si-jun;TU Ji-tao(Department of General Surgery,Huangshi Central Hospitalb Puai Branch Hospital,Affiliated Hospital of Hubei Pohytechnic University,Edong Healthcare Group(Huangshi Hubei,435000)China)
出处
《中西医结合肝病杂志》
CAS
2022年第2期135-138,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
关键词
腹腔镜解剖性肝叶切除术
肝内胆管结石
疗效
安全性
laparoscopic anatomicalal lobectomy
intrahepatic bile duct stones
efficacy
safety
作者简介
通讯作者:涂霁韬,E-mail:648995004@qq.com。
