王东君 白雨昕

【摘要】 目的：探討腹腔镜胆囊切除术治疗对胆结石患者的临床有效性。方法：选取2018年12月-2019年12月本院收治的胆结石患者144例为研究对象，依据随机数字表法将其分为两组，每组72例。对照组应用开腹胆囊切除术治疗，研究组应用腹腔镜胆囊切除术治疗。两组的治疗效果、术后并发症、术后VAS评分以及手术时间、下床活动时间、住院天数、术中出血量、肠道排气时间。结果：研究组疗效高于对照组（P<0.05），同时研究组并发症低于对照组（P<0.05）。术前两组患者VAS评分比较，差异无统计学意义（P>0.05）;术后6、12、24 h的VAS评分均低于对照组，两组比较差异有统计学意义（P<0.05）。研究组手术时间、肠道排气时间、住院天数以及下床活动时间均短于对照组（P<0.05），同时研究组患者术中出血量低于对照组（P<0.05）。结论：应用腹腔镜胆囊切除术可以减少胆结石患者在术中出血量，缩短手术时间，降低对患者胆囊周围组织的损害，减轻患者疼痛，有利于患者早日恢复，值得临床上大力推广应用。

【关键词】 腹腔镜胆囊切除术 胆结石 并发症 VAS评分

Clinical Efficacy of Laparoscopic Cholecystectomy in Patients with Gallstones/WANG Dongjun， BAI Yuxin. //Medical Innovation of China， 2021， 18（01）： -167

[Abstract] Objective： To explore the effect of laparoscopic cholecystectomy on the clinical efficacy， complications and VAS score of patients with gallstones. Method： A total of 144 patients with gallstones admitted to our hospital from December 2018 to December 2019 were selected as the study objects， they were divided into two groups according to the random number table method， 72 cases in each group. The control group was treated with open cholecystectomy， and the research group was treated with laparoscopic cholecystectomy. The results of treatment， postoperative complications， postoperative VAS score， operation time， time of getting out of bed， length of stay， intraoperative blood loss and intestinal exhaust time of two groups were compared. Result： The curative effect of the study group was higher than that of the control group （P<0.05）， and the complication of the study group was lower than that of the control group （P<0.05）. There was no significant difference in VAS score between the two groups before operation （P>0.05）; the VAS scores at 6， 12 and 24 h after operation were lower than those in the control group （P<0.05）. The operation time， intestinal exhaust time， hospitalization days and ambulation time of the study group were shorter than those of the control group （P<0.05）， and the intraoperative blood output of the study group was lower than that of the control group （P<0.05）. Conclusion： Laparoscopic cholecystectomy for cholelithiasis patients can reduce the amount of intraoperative bleeding， shorten the operation time， reduce the damage to the patient's tissues， is conducive to the recovery of gastrointestinal function， and also reduce the postoperative pain of patients， which is worthy of clinical application.

[Key words] Laparoscopic cholecystectomy Gallstones Complications VAS score

First-authors address： Jiamusi Central Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.01.040

随着社会发展，生活水平提高，高脂肪食物摄入量增多，致使胆结石发生率愈发增高。胆结石能堵塞胆囊管，引起胆囊积聚胆汁，从而影响到患者胆囊功能，降低其生活质量[1]。胆结石是临床上一种常见的多发疾病，这种疾病的发病原因比较复杂，一定程度上与患者的饮食习惯有着很大的关系。胆结石通常会合并存在胆囊炎，两者同时出现时就会互相影响，从而使周边组织和胆囊出现粘连。根据临床调查显示，男女患病比例为1︰2，女性病患高于男性病患，多发于老年人群[2]。临床治疗大多以手术为主，随着腹腔镜技术的不断发展，临床中多以腹腔镜胆囊切除术对胆结石患者进行治疗，并取得了较为理想的疗效[3]。本研究选取本院收治的胆结石患者，给予腹腔镜胆囊切除术治疗，取得不错效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年12月-2019年12月本院收治的胆结石患者144例为研究对象，依据随机数字表法将其分为两组，每组各72例，上述患者均已通过CT、X线等影像检查手段予以确诊。……