经脐单孔腹腔镜切除胆囊40例临床分析

唐宗怀+国维克+韩亮+程晓剑

【摘要】目的探讨经脐单孔腹腔镜切除胆囊的临床效果和安全性。方法选取本院2010年2月~ 2014年1月收治的胆囊炎患者80例作为研究对象, 并分为对照组和观察组, 每组各40例。两组患者接受相同的围手术期护理和治疗, 对照组患者采用传统三孔腹腔镜法切除胆囊, 观察组患者接受经脐单孔腹腔镜切除胆囊。比较两组患者的手术时间、术中出血量、住院时间、术后并发症发生情况以及患者对疼痛和切口美观程度评价。结果两组患者术中出血量以及住院时间基本相同, 但观察组患者手术时间较长, 且观察组患者并发症发生率显著低于对照组, 差异有统计学意义(P<0.05)。观察组患者VAS疼痛评分低于对照组, 且对腹部美观评分高于对照组, 差异有统计学意义(P<0.05)。结论经脐单孔腹腔镜切除胆囊效果在保证疗效的基础上, 有助于降低并发症, 减少患者痛苦, 增加美观度, 值得临床推广。

【关键词】经脐单孔腹腔镜；胆囊炎；并发症

Clinical analysis of 40 cases of transumbilical single port laparoscopic cholecystectomy TANG Zong-huai, GUO Wei-ke, HAN Liang, et al. Tongling Municipal Hospital, Tongling 244000, China

【Abstract】Objective To explore the clinical efficacy and safety of transumbilical single port laparoscopic cholecystectomy. Methods Choosing 80 cholecystitis patients as research subjects from february 2010 from January 2014 and dividing them into control group and observation group, 40 cases in each group. Two groups of patients received the same perioperative care and treatment in the control group were treated with conventional three-hole laparoscopic cholecystectomy, observation group patients after laparoscopic cholecystectomy umbilical hole. Two groups were compared operative time, blood loss, hospital stay, postoperative complications, and patient assessment of pain and cuts beautifully occurred. Results The two groups of patients with blood loss and hospital stay basically the same, but the observation group were longer operative time, and complication rate in patients in the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05). VAS pain scores of patients in the observation group than the control group, and the beautiful score higher on the abdomen, the difference was statistically significant(P<0.05). Conclusion Transumbilical single port laparoscopic cholecystectomyon on the basis of ensuring the efficacy, also can help reduce complications and suffering of patients and increase aesthetics, so it is worthy of clinical promotion.

【Key words】Transumbilical single port laparoscopy; Cholecystitis; Complications作者单位：244000安徽省铜陵市立医院外一科(唐宗怀国维克)；安徽省铜陵市人民医院急诊外科(韩亮), 外一科(程晓剑)随着医疗水平的发展, 微创手术已广泛应用于临床, 其中腹腔镜手术已成为最为常用的微创术式, 且凭借其显著的微创优势成为胆囊良性疾病外科治疗的金标准［1］。目前, 临床腹腔镜切除胆囊多采用三孔、四孔法置入器械, 部分伴有并发症, 且不能满足现代人对美观的要求。经脐单孔腹腔镜通过作为胚胎时期自然孔道的脐, 能够达到隐藏腹部瘢痕的效果, 又避免了经胃、直肠、膀胱或阴道的感染问题, 也降低了手术难度［2］。近期, 本院使用经脐单孔腹腔镜切除胆囊, 现报告如下。

1资料与方法

1. 1一般资料选取本院2010年2月~2014年1月间收治的胆囊炎患者80例作为研究对象, 并随机分为对照组和观察组, 每组各有患者40例。……