【摘要】 目的评价一次性切口牵开固定器在腹腔镜辅助硬质胆道镜保胆取石术中的应用。方法选取2011年3月—2012年3月保胆取石术患者100例,采用随机数字表法分为2组,腹腔镜辅助硬质胆道镜保胆取石术组(C组,n=50),腹腔镜辅助经一次性切口牵开固定器硬质胆道镜保胆取石术组(X组,n=50),比较2组手术时间、气腹时间、术中出血量、术后肠蠕动恢复时间、术后应用镇痛药物例数、住院时间及术后复发情况。结果 X组在手术时间、术中出血量、术后肠蠕动恢复时间、术后应用镇痛药物例数均短于或少于C组(P<0.05),而2组气腹时间、住院时间差异无统计学意义(P>0.05)。2组术后均无腹腔感染、腹腔出血、胆漏、粘连性肠梗阻并发症出现,随访12个月,未发现胆囊结石复发。结论将一次性切口牵开固定器应用在保胆取石术中安全可行,具有手术创伤小等优点,值得临床推广。更多还原

【Abstract】 Objective Through the comparison of various aspects of laparoscopic assisted by rigid choledochoscope gallbladder-preserving cholelithotomy and laparoscopic assisted by disposable incision retractor fixator and rigid choledochoscope gallbladder-preserving cholelithotomy in intraoperative,postoperative,to clarify the application value of disposable incision retractor fixator in gallbladder-preserving cholelithotomy.Methods From March 2011 to March 2012,100 cholecystolithotomy cases were studied,and the patients were randomed into two groups:laparoscopic assisted by rigid choledochoscope gallbladder-preserving cholelithotomy(control group) 50 cases, laparoscopic assisted by disposable incision retractor fixator and rigid choledochoscope gallbladderpreserving cholelithotomy(observation group) 50 cases.Comparative analysis of two groups involved operation time,pneumoperitoneum time,intraoperative bleeding volume,postoperative intestinal peristalsis recovery time,postoperative analgesia,hospitalization time and postoperative follow-up survey.Results In the operation time,bleeding volume,recovery time of intestinal peristalsis,application of analgesic drugs,the observation group is better than the control group.But the pneumoperitoneum time, hospitalization time showed no significant difference between two groups.There were no postoperative abdominal infection,abdominal bleeding,bile leakage,adhesive intestinal obstruction complications, follow-up of 12 months,no recurrence of cholecystolithiasis in both groups.Conclusion The disposable incision retractor fixator for cholecystolithotomy shows advantages suchas small trauma and others is safe and feasible in gallbladder-preserving cholelithotomy,and it is worth clinical promotion.更多还原