【摘要】 目的比较分析胆结石采用微创保胆取石术与腹腔镜胆囊切除术治疗的效果以及对患者生活质量的影响。方法 98例胆结石患者,根据治疗方法不同分为A组(采用微创保胆取石术)和B组(采用腹腔镜胆囊切除术),各49例。比较两组手术相关指标、术后并发症发生情况,并随访12个月,观察术后6、12个月患者生活质量及随访期间复发情况。结果 A组患者术中出血量、手术时间、开始下床活动时间、住院时间均明显少于B组,差异具有统计学意义(P<0.05)。A组术后6、12个月消化病生存质量指数(GLQI)评分均明显高于B组,差异具有统计学意义(P<0.05)。A组胆管损伤、术后感染发生率分别为2.0%、2.0%,与B组的4.1%、2.0%比较差异无统计学意义(P>0.05)。随访12个月,两组患者均未出现复发,复发率均为0。结论微创保胆取石术比腹腔镜胆囊切除术更具有微创优势,同时对患者术后生活质量影响小,总体手术安全性高,在满足适应证的情况下可优先采用。更多还原

【Abstract】 Objective To compare and analyze the effect of minimally invasive cholecystolithotomy and laparoscopic cholecystectomy in the treatment of cholelithiasis and its effect on the quality of life. Methods A total of 98 cholelithiasis patients were divided by different treatment methods into group A(minimally invasive cholecystolithotomy) and group B(laparoscopic cholecystectomy), with 49 cases in each group. Comparison were made on operation related indicators and occurrence of postoperative complications between the two groups. Both groups were followed-up for 12 months, and the quality of life and the recurrence condition were observed at 6 and 12 months after operation. Results Group A had obviously less intraoperative bleeding volume, operation time, first off-bed activity time and hospitalization time than group B, and the difference was statistically significant(P<0.05). Group A had obviously higher gastrointestinal quality of life index(GLQI) score than group B at 6 and 12 months after operation, and the difference was statistically significant(P<0.05). Group A had no statistically significant difference in incidence of bile duct injury and postoperative infection respectively as 2.0% and 2.0%, comparing with 4.1% and 2.0% in group B(P>0.05). After 12 months of follow-up, no recurrence occurred in both groups, and the recurrence rate was 0. Conclusion Minimally invasive cholecystolithotomy is more minimally invasive than laparoscopic cholecystectomy, and it has little influence on the quality of life of patients. The overall surgical safety is high and can be used preferentially when the indication is satisfied.更多还原