秦桂跃

[摘要] 目的 探讨微创保胆取石对胆结石患者身心状态影响效果。 方法 选择我科收治的246例胆结石患者，随机分为观察组（予以微创保胆取石术）、对照组（予以腹腔镜胆囊切除术），每组各123例，觀察两组患者残石率、住院总费用、术后住院时间、术中出血量、随访1年后的复发率、并发症发生率，以及血清中的总胆红素、血清丙氨酸基转移酶水平，随访1年观察两组患者不良情绪变化情况。 结果 与对照组比较，观察组患者的残石率、复发率均为0.81%，并发症发生率为1.62%，住院总费用（0.62±0.05）分、术后住院时间（5.20±1.00）分、术中出血量（110.51±10.89）mL，均降低明显，差异有统计学意义（P<0.05）。术后第1天，两组患者的免疫功能比较差异均无统计学意义（P>0.05）；术后第30天，与对照组比较，观察组患者的总胆红素、血清丙氨酸基转移酶水平均降低明显，差异有统计学意义（P<0.05）；术前两组患者的不良情绪评分SAS、SDS差异均无统计学意义（P>0.05）；随访1年，与对照组比较，观察组患者的不良情绪评分均亦降低明显，差异有统计学意义（P<0.05）。 结论 微创保胆取石术可较好的改善胆结石患者胆功能，提高疗效，降低术后并发症及不良情绪发生，对于预后身心症状均有明显改善。

[关键词] 微创保胆取石术；胆结石；疗效；胆功能；情绪

[中图分类号] R604 [文献标识码] A [文章编号] 2095-0616（2017）20-193-04

Analysis of effect of minimally invasive gallbladder preserving stone extraction on physical and mental state of patients with gallstone

QIN Guiyue

Department of General Surgery，Traditional Chinese Medicine Hospital of Taizhou City，Taizhou 225300，China

[Abstract] Objective To discuss the effect of minimally invasive gallbladder preserving stone extraction on physical and mental state of patients with gallstone. Methods 246 patients with gall-stone treated in our department were selectedand randomly divided into observation group （who were adopted minimally invasive gallbladder preserving lithotomy） and control group （who were adopted laparoscopic cholecystectomy），123 cases patients in each group.The rate of residual stone，total hospitalization expenses，postoperative hospital stay，blood loss，recurrence rate，complication rate，serum total bilirubin and serum alanine transferase level of two group patients were observed.After 1 years of follow-up，two groups of patients were observed adverse emotional changes. Results Compared with the control group，the observation group of patients with residual stone rate，the recurrence rate was 0.81%，the complication rate was 1.62%，the total cost of hospitalization （0.62±0.05），hospitalization time after operation （5.20±1.00），bleeding （110.51±10.89）mL，decreased significantly，the difference was statistically meaning （P<0.05）.After the 1D，the difference of immune function in the patients of the two groups were not statistically significant （P>0.05）；30d after operation， compared with the control group， the observation group of patients with total bilirubin，serum alanine aminotransferase levels decreased significantly， the difference was statistically significant （P<0.05）；Before the operation，two groups of patients with bad mood scores of SAS，SDS showed no significant difference （P>0.05）；1 years of follow-up，compared with the control group，bad mood scores in observation group were also significantly lower，the difference was statistically significant （P<0.05）. Conclusion Minimally invasive gallbladder preserving lithotomy can relatively better improve gall-stone patients gall function，improve the curative effect，reduce post-operation complication and bad mood occurrence，to prognosis physical and psychological symptoms all can obviously improve.endprint

[Key words] Minimally invasive gallbladder preserving lithotomy；Gall-stone；Curative effect；Gall function；Mood

胆石症属于消化外科常见疾患之一，是由于胆囊内部结石而诱发的疾患，近年来，随着生活方式及饮食习惯的变化，胆石症的发病率渐趋增加，多见于成年人，且男性为多[1]，因此探讨其干预措施是现今外科医务人员需要解决的问题，既往临床对其治疗较为单一，但若失治误治则容易诱发并发症，进而影响患者的生活与工作[2]，因此，我科在查阅文献的基础上，结合实际情况，采用微创保胆取石对胆结石患者进行治疗，并与常规干预措施进行对照，观察两组患者的气腹并发症的治疗效果，并随访观察患者的不良情绪及生活质量，以期探讨可有效治疗胆石症的措施，保障人们健康。……