【摘要】 目的对比研究两孔法保胆取石术与腹腔镜胆囊切除术(LC)治疗胆囊结石的远期预后及生活质量。方法选取2013年1月至2015年12月本院收治的115例胆囊结石患者,根据随机抽签法分为观察组(58例)和对照组(57例)。对照组采取LC,观察组采取两孔法保胆取石术。评价两组患者的术中、术后恢复情况、远期预后情况及生活质量。结果观察组患者的手术时间、切口长度显著短于对照组[(41.32±4.32)min vs(56.32±5.43)min,(3.43±0.42)cm vs(5.65±0.76)cm],术中出血量明显少于对照组[(38.43±4.32)mL vs(46.98±4.54)mL],差异均有统计学意义(P<0.05)。观察组的禁食时间、术后排气时间、下床活动时间、抗菌治疗时间、住院时间显著短于对照组[(1.39±0.42)d vs(2.04±0.56)d,(1.32±0.14)d vs(2.22±0.21)d,(1.51±0.46)d vs(2.41±0.74)d,(1.94±0.42)d vs(2.87±0.65)d,(5.43±0.87)d vs(8.32±1.55)d](均P<0.05)。术后6个月,观察组的主观症状、生理状态、心理状态、社会活动及日常生活状态、生活质量总分显著高于对照组[(67.43±6.32)分vs(60.24±5.98)分,(19.98±2.04)分vs(17.54±1.76)分,(18.32±1.57)分vs(15.43±1.41)分,(11.43±1.42)分vs(9.14±0.56)分,(117.16±10.43)分vs(108.43±9.32)分](P<0.05)。观察组总的不良预后率显著低于对照组[3.45%(2/58)vs 15.79%(9/57)](P<0.05)。结论相对于LC,胆囊结石患者采取腹腔镜下保胆取石术进行治疗,其临床效果及远期预后更为显著,有利于患者生活质量的提高。更多还原

【Abstract】 Objective To compare the long-term prognosis and the life quality between two-port cholecystolithotomy and laparoscopic cholecystectomy for gallbladder stones patients.Methods A total of 115 gallstone patients were collected from Jan.2013 to Dec.2015 in our hospital,according to the random draw method,all patients were divided into observation group(58 cases) and control group(57 cases).Control group received the laparoscopic cholecystectomy(LC),observation group received two-port cholecystolithotomy.The intraoperative and postoperative recovery,long-term prognosis and quality of life between two groups were compared.Results For observation group,the operation time,length of incision were significantly shorter than those in the control group[(41.32±4.32)min vs(56.32±5.43)min,(3.43±0.42)cm vs(5.65±0.76)cm],intraoperative blood loss was less than that in control group[(38.43±4.32)mL vs(46.98±4.54)mL],the difference all had statistical significance(P<0.05).In observation group,the fasting time,bed time,postoperative exhaust time,antimicrobial treatment time,and length of hospital stay were significantly shorter than those in the control group[(1.39±0.42)d vs(2.04 ±0.56)d,(1.32±0.14)d vs(2.22±0.21)d,(1.51±0.46)d vs(2.41±0.74)d,(1.94±0.42)d vs(2.87±0.65)d,(5.43±0.87)d vs(8.32±1.55)d](all P<0.05).After 6 mon,the subjective symptoms,physiology,psychology,social activities and daily life,the quality of life score in observation group were significantly higher than those in the control group[(67.43±6.32)points vs(60.24±5.98)points,(19.98±2.04)points vs(17.54±1.76)points,(18.32±1.57)points vs(15.43±1.41)points,(11.43±1.42)points vs(9.14±0.56)points,(117.16±10.43)points vs(108.43±9.32)points](all P<0.05).Overall poor prognosis rate in the observation group was significantly lower than that in the control group[3.45%(2/58) vs 15.79%(9/57)](P<0.05).Conclusion For patients with gallbladder stone,two-port cholecystolithotomy can obtain better clinical effect and long-term prognosis,which is beneficial to improve patients’ life quality.更多还原