滕方遒

[摘要] 目的：探讨腹腔镜手术治疗肝硬化合并胆囊结石的可行性及疗效分析。方法：选取我院68例肝硬化合并胆囊结石患者，随机分为两组，开腹治疗组为对照组（34例），腹腔镜组为观察组（34例），分别比较两组患者手术前后的各项指标。结果：两组患者在性别、年龄构成比和肝功能分级方面比较，差异均无统计学意义（P＞0.05），具有可比性。对照组术中出血量[（192.1±42.6）ml]、手术时间[（122.6±25.4）min]、术后禁食时间[（2.7±0.9）d]和术后住院时间[（9.3±1.8）d]均高于观察组[（79.9±38.7）ml、（63.3±21.8）min、（1.0±0.6）d、（4.2±1.1）d]，两组比较差异有统计学意义（P＜0.05）；对照组在术后1、7 d总胆红素[（33.7±9.9）、（19.6±6.2）μmol/L]和丙氨酸氨基转移酶[（188.9±22.6）、（46.2±13.1）U/L]均高于观察组[（26.3±7.2）、（16.9±7.3）μmol/L，（137.1±11.5）、（38.0±6.8）U/L]，两组比较差异有统计学意义（P＜0.05）。其余指标比较差异无统计学意义（P＞0.05）。结论：腹腔镜手术治疗肝硬化合并胆囊结石患者方案是安全可行的，能够取得满意的疗效，值得临床上广泛推广应用。

[关键词] 腹腔镜；肝硬化；胆囊结石

[中图分类号] R657.3+1；R657.4+2 [文献标识码]Ａ [文章编号]1673-7210（2011）11（c）-047-03

Feasibility and efficacy analysis of laparoscopic surgery in treating liver cirrhosis merger cystic and calculus

TENG Fangqiu

Department of Surgery, People's Hospital of Jingzhou County, Hu′nan Province, Jingzhou 418400, China

[Abstract] Objective: To explore the feasibility and efficacy analysis of laparoscopic surgery in treating liver cirrhosis merger cystic and calculus. Methods: 68 liver cirrhosis merger cystic and calculus patients in our hospital were selected, and they were randomly divided into two groups, patients in treatment group were treated by laparotomy, patients in observation group were treated by laparoscopic, each 34 cases. The indexes before and after operation of the two groups were compared. Results: There were no significant differences of the two groups in sex, age composition and liver function classification (P>0.05). The control group in peri-operative bleeding [(192.1±42.6) ml], operation time [(122.6±25.4) min], postoperative fasting time [(2.7±0.9) d] and postoperative hospitalization time [(9.3±1.8) d] were higher than those of the observation group[(79.9±38.7)ml, (63.3±21.8)min, (1.0±0.6)d, (4.2±1.1)d], there were significant differences between the two groups (P＜0.05). The control group in postoperative 1 and 7 days total bilirubin[(33.7±9.9), (19.6±6.2) μmol/L] and alanine aminotransferase [(188.9±22.6), (46.2±13.1) U/L] were higher than those of the observation group [(26.3±7.2) μmol/L, (16.9±7.3) μmol/L, (137.1±11.5)U/L, (38.0±6.8)U/L], there were significant differences between the two groups (P＜0.05）. There was no significant difference of the rest indexes between the two groups (P>0.05). Conclusion: Laparoscopic operation in the treatment of patients with cholelithiasis combined with liver cirrhosis scheme is safe and feasible, which can obtain satisfactory curative effect, and it is deserved clinical widely.

[Key words] Laparoscopic; Liver cirrhosis; Gallbladder stones

有研究表明，随着国内围术期治疗的完善和发展，由于腹腔镜器械的改进和医务工作人员技术水平的提高，腹腔镜胆囊切除术正在逐步扩大并被广大医务工作者和患者所接受，现已有很多关于其用于治疗肝硬化合并胆囊结石疾病的报道，并显示出其具有明显的优越性[1]。为了探讨腹腔镜手术治疗肝硬化合并胆囊结石的可行性及疗效，针对我院68例患者进行研究，现将结果报道如下：

1 资料与方法

1.1 一般资料

选取我院2009~2011年肝硬化合并胆囊结石患者68例，年龄为39~72岁，平均（53.7±17.4）岁。随机分为两组，开腹治疗组为对照组（34例），其中，男21例，女13例；……