摘要
目的:比较腹腔镜手术与开放手术治疗肝内胆管结石的临床效果。方法:选取2023年1月—2024年12月于徐州矿务集团总医院接受手术治疗的82例肝内胆管结石患者,采用随机数字表法将患者分为腹腔镜组(43例)与开放手术组(39例)。腹腔镜组接受腹腔镜手术,开放手术组接受开放手术。比较两组手术指标、结石清除率、并发症发生情况及肝功能。结果:两组手术时间比较,无统计学差异(P>0.05);腹腔镜组术中出血量少于开放手术组(P<0.001),肠鸣音恢复时间早于开放手术组(P<0.001),术后住院时间短于开放手术组(P<0.001)。两组结石清除率比较,无统计学差异(P>0.05)。腹腔镜组并发症总发生率低于开放手术组(P=0.043)。术后第3天,腹腔镜组丙氨酸氨基转移、天冬氨酸氨基转移酶、总胆红素、直接胆红素、碱性磷酸酶水平低于开放手术组(P<0.05)。结论:腹腔镜手术治疗肝内胆管结石的临床效果优于开放手术,可在确保结石清除效果的同时,减轻术中创伤、加速术后恢复、保护肝功能并降低并发症发生风险。
Objective:To compare the clinical effects of laparoscopic surgery and open surgery in the treatment of intrahepatic bile duct stones.Methods:A total of eighty-two patients with intrahepatic bile duct stones who underwent surgical treatment at Xuzhou Coal Group General Hospital from January 2023 to December 2024 were selected.The patients were divided into the laparoscopic group(43 cases)and the open surgery group(39 cases)by the random number table method.The laparoscopic group received laparo‐scopic surgery,while the open surgery group received open surgery.The surgical indicators,stone clearance rate,occurrence of com‐plications and liver function of the two groups were compared.Results:There was no statistically significant difference in the opera‐tion time between the two groups(P>0.05).The intraoperative blood loss in the laparoscopic group was less than that in the open surgery group(P<0.001).The recovery time of bowel sounds was earlier than that in the open surgery group(P<0.001),and the post‐operative hospital stay was shorter than that in the open surgery group(P<0.001).There was no statistically significant difference in the stone clearance rate between the two groups(P>0.05).The total incidence of complications in the laparoscopic group was lower than that in the open surgery group(P=0.043).On the third day after the operation,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin and alkaline phosphatase in the laparoscopic group were lower than those in the open surgery group(P<0.05).Conclusion:The clinical effect of laparoscopic surgery in the treatment of intrahepatic bile duct stones is superior to that of open surgery.It can ensure the stone removal effect while reducing intraoperative trauma,accelerating postop‐erative recovery,protecting liver function and lowering the risk of complications.
作者
李海青
Li Haiqing(Department of General Surgery,Xuzhou Coal Group General Hospital/the Second Affiliated Hospital of Xuzhou Medical University,Xu-zhou 221000,Jiangsu Province,China)
出处
《中外医药研究》
2025年第18期40-42,共3页
JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH
关键词
肝内胆管结石
腹腔镜手术
开放手术
术后恢复
Intrahepatic bile duct stones
Laparoscopic surgery
Open surgery
Postoperative recovery
