【摘要】 目的研究分析微创内镜保胆取息肉术治疗胆囊息肉的临床疗效、并发症及远期预后,为胆囊息肉临床有效治疗提供科学指导。方法回顾性分析2012年6月至2015年6月诊治的125例胆囊息肉患者临床资料,随机将其分为两组。对照组55例行腹腔镜胆囊切除术治疗,研究组70例行微创内镜保胆取息肉术。对比两组患者围术期指标、并发症、胆囊壁厚度与胆囊收缩功能改善以及远期预后效果。结果研究组手术时间、肠功能恢复时间、肛门排气时间、住院时间依次为(50.01±11.84)min、(21.23±3.14)h、(17.62±4.25)h、(4.15±1.25)d均短于对照组(62.12±3.14)min、(42.26±4.25)h、(27.55±5.14)h、(9.82±3.25)d,出血量(11.25±2.47)ml、术后VAS评分(2.67±1.25)分均少于对照组(17.26±3.02)ml、(7.56±1.81)分(P<0.01);两组术后胆囊壁厚度、胆囊收缩功能均改善,且研究组改善优于对照组(P<0.01);研究组息肉复发7.14%低于对照组25.45%。结论微创内镜保胆取息肉术治疗胆囊息肉效果显著,未发生胆瘘、出血等严重并发症,且可改善患者胆囊收缩功能,降低息肉复发率,具有临床推广价值。更多还原

【Abstract】 Objective To explore the effect of endoscopic minimally invasive polypectomy with gallbladder preservation on the clinical effect,complications and long- term prognosis in the treatment of cholecystic polypus. Methods The clinical data of 125 patients with gallbladder polyps admitted to our hospital between June 2012 and June 2015 were reviewed,which were divided into two groups according to the different treatments given. The 55 patients in the control group were treated by laparoscopic cholecystectomy,whereas the 70 patients in the study group were given endoscopic minimally invasive polypectomy with gallbladder preservation for treatment. The perioperative indicators,complications,gallbladder wall thickness and gallbladder contraction function as well as the long- term prognosis effect in the two groups were compared. Results The operation duration,recovery time for intestinal function,anal exhaust time and hospital stay in the study group were respectively( 50. 01 ± 11. 84) min,( 21. 23 ± 3. 14) h,( 17. 62 ± 4. 25) h,( 4. 15 ± 1. 25) d,shorter than those in the control group,which were respectively( 62. 12 ± 3. 14) min,( 42. 26 ± 4. 25) h,( 27. 55 ± 5. 14) h and( 9. 82 ± 3. 25) d. The bleeding volume and postoperative VAS score in the study group were respectively( 11. 25 ± 2. 47) ml and( 2. 67 ± 1. 25),both lower than those of the study group,where thebleeding volume was( 17. 26 ± 3. 02) ml and the VAS score was( 7. 56 ± 1. 81)( P < 0. 01). Recurrence rate of nasal polyps in the study group was 7. 14 %,lower than that in the control group,which was 25. 45 %. Conclusion Endoscopic minimally invasive polypectomy with gallbladder preservation is with significant curative effect in the treatment of gallbladder polyps,producing no occurrence of biliary fistula,bleeding and other serious complications,and it can improve the gallbladder contraction function and reduce the recurrence rate,thus worthwhile to be put into clinical application.更多还原