摘要
目的探析胆总管不同缝线方式在腹腔镜胆总管切开取石术中的效果。方法该文随机抽取该院2018年6月—2020年6月收治的76例胆总管结石患者,随机分组,对照组(n=38)行可吸收缝线连续缝合胆总管,观察组(n=38)行V-lock缝线连续缝合胆总管,对比两组血清指标以及临床指标。结果观察组术后血清ALT、AST、TBIL、MAPK水平分别为(57.31±8.42)U/L、(55.62±12.95)U/L、(29.15±3.82)μmol/L、(4.01±0.82)μg/mL,均低于对照组,差异有统计学意义(t=6.080、2.446、6.147、6.706,P<0.05),观察组胆总管缝合时间、出血量、拔除T管时间、住院时间分别为(10.32±5.01)min、(31.26±8.11)mL、(21.02±5.62)d、(6.01±1.23)d低于对照组,差异有统计学意义(t=4.445、15.049、3.260、7.304,P<0.05)。观察组出血发生率为2.63%,拔管困难发生率为5.26%,胆漏发生率为2.63%,胆道狭窄发生率为2.63%均低于对照组,差异有统计学意义(χ^(2)=4.537、5.208、4.537、4.537,P<0.05)。结论对于胆总管结石患者而言,腹腔镜胆总管切开取石术属于常见术式,治疗效果显著,并且与可吸收缝线相比,通过应用V-lock缝线连续缝合胆总管,可优化患者ALT、AST、TBIL、MAPK等血清指标,有利于加快肝功能恢复速度,并进一步缩短患者胆总管缝合时间以及拔除T管时间、住院时间,能够降低患者术中出血量,在优化患者治疗效果的同时,可促进患者早日康复,并且还可以改善患者出血、拔管困难、胆漏、胆道狭窄等并发症发生率,治疗安全性较高,具有推广价值。
Objective To explore the effect of different suture methods of the common bile duct in laparoscopic choledochostomy.Methods Randomly selected 76 patients with common bile duct stones admitted to the hospital from June 2018 to June 2020 were randomly divided into groups.The control group(n=38)was continuously sutured with absorbable sutures,and the observation group(n=38)was continuously sutured with V-lock sutures.The serum and clinical indicators of the two groups were compared.Results The postoperative serum ALT,AST,TBIL and MAPK levels in the observation group were(57.31±8.42)U/L,(55.62±12.95)U/L,(29.15±3.82)μmol/L,(4.01±0.82)μg/mL were lower than those in the control group,the difference was statistically significant(t=6.080,2.446,6.147,6.706,P<0.05),the observation group's common bile duct suture time,blood loss,T tube removal time,and hospital stay were respectively was(10.32±5.01)min,(31.26±8.11)mL,(21.02±5.62)d,(6.01±1.23)d lower than the control group,the difference was statistically significant(t=4.445,15.049,3.260,7.304,P<0.05).The incidence of bleeding in the observation group was 2.63%,the incidence of difficult extubation was 5.26%,the incidence of biliary leakage was 2.63%,and the incidence of biliary stricture was 2.63%,all were lower than those of the control group,the difference was statistically significant(χ^(2)=4.537,5.208,4.537,4.537,P<0.05).Conclusion For patients with choledocholithiasis,laparoscopic choledocholithotomy is a common operation,and the treatment effect is significant.Compared with absorbable sutures,continuous suture of the common bile duct with V-lock sutures can optimized the Serum indicators,such as ALT,AST,TBIL,MAPK,etc.help to accelerate the recovery of liver function,and further shorten the time for suture of the common bile duct,the time for removal of the T tube,and the length of hospital stay,which can reduce the amount of intraoperative blood loss and optimize the treatment effect of the patient.At the same time,it can promote the patient's early recovery,and can also improve the incidence of complications such as bleeding,difficult extubation,bile leakage,biliary stricture,etc.The treatment is safer and has promotion value.
作者
林春冬
吴路鹏
李志民
谢锦居
LIN Chundong;WU Lupeng;LI Zhimin;XIE Jinju(General Surgery,Xinglin Branch,First Affiliated Hospital of Xiamen University,Xiamen,Fujian Province,361022 China)
出处
《中外医疗》
2021年第34期55-58,共4页
China & Foreign Medical Treatment
关键词
腹腔镜胆总管切开取石术
胆总管
不同缝线方式
Laparoscopic choledocholithotomy
Common bile duct
Different suture methods
