【摘要】 目的探讨腹腔镜胆囊切除术患者术中腹腔引流术的优缺点及应用。方法选取我院2015年3月~2016年4月因有临床症状而需要择期行腹腔镜胆囊切除术治疗的胆囊结石患者80例。80例患者在手术前随机分为两组。A组40例,术中常规在肝下间隙放置腹腔引流管。B组40例,术中不放置腹腔引流管。术后疼痛评估使用10点视觉模拟量表。对两组患者术后疼痛、手术时间、术后住院时间及术后并发症发生率情况进行比较分析。结果 A组平均手术时间较B组长,但差异无统计学意义(P>0.05)。两组术后6h疼痛平均视觉模拟评分相近,A组术后24h、48h疼痛平均视觉模拟评分较B组高,差异有统计学意义(P<0.05)。住院3d以上的患者A组为18例(45.0%),高于B组的8例(20.0%),差异有统计学意义(P<0.05)。两组术后伤口感染、右肩背部疼痛、恶心、呕吐和呼吸道感染率差异无统计学意义(P>0.05)。结论择期腹腔镜胆囊切除术中胆囊床的常规腹腔引流可能不合理,可出现更多的术后疼痛,术后并发症多,且延长了住院时间。更多还原

【Abstract】 Objective To evaluate the advantages and disadvantages of drainage in patients undergoing laparoscopic cholecystectomy.Methods Eighty patients underwent laparoscopic cholecystectomy for symptomatic gall stone in our hospital from Mar 2015 to Apr 2016 were selected and randomly divided into two groups surgical procedure.40 cases in group A were placed abdominal drainage tube within intrahepatic space.40 cases in group B were not placed abdominal drainage tube in operation.Postoperative pain was assessed using 10-point visual analog scale.The postoperative pain,operation time,length of postoperative hospital stay and the incidence of postoperative complications of the two groups were evaluated and compared.Results The mean operative time in group A was longer than that in group B(P>0.05).Although the postoperative mean pain score was close at 6 hours after surgery in both groups,it was higher in group A at 24 hours and 48 hours after surgery compared with group B(P<0.05).The proportion of patients who were hospitalized for more than 3 days in A group was higher than that in B group(P<0.05).There was no statistical difference in the rate of wound infections,shoulder pain,nausea,vomiting,and respiratory infections between the two groups.Conclusion The routine drainage of gallbladder bed after elective laparoscopic cholecystectomy may not be justified and appear to cause more postoperative pain and more postoperative complications and prolongs the hospital stay.更多还原