微创医学

目的探讨十二指肠镜微创治疗和开腹胆总管探查术治疗胆总管结石的临床疗效及其对心肺功能的影响。方法 30例患者采用十二指肠镜微创治疗(微创治疗组),另30例患者施行传统开腹胆总管探查术(传统开腹组),观察两组的手术时间、术后禁食天数、术后并发症、结石清除率、术后住院时间和临床疗效,分析微创治疗组术前、术中、术后收缩压、舒张压、心率、脉搏和血氧饱和度的变化。结果微创治疗组28例1次取石成功,2例插管不成功,需行第2次微创治疗才成功取石;微创治疗组在手术时间、术后禁食天数、术后住院时间均优于传统开腹组(P<0.05);微创治疗组结石清除率93.33%,传统开腹组结石清除率96.67%,两组结石清除率比较,差异无统计学意义(P>0.05);微创治疗组术后出现并发症1例,传统开腹组出现8例,差异有统计学意义(P<0.05);微创治疗过程中HR(次/min)明显高于治疗前及治疗后(P<0.05),SpO2、SBP、DBP治疗前、治疗中、治疗后比较,差异无统计学意义(P>0.05)。结论十二指肠镜微创治疗胆总管结石安全、有效,且对病人心肺功能无明显影响,可成为治疗胆总管结石的首选方法。

Objeetive To explore the clinical value and cardiorespiratory function influence of duodenoseope minimany invasive treatment and open common bile duct exploration(OCBDE)．Methods 30 cases were treated with duodenc~ scope minimally invasive treatment，and the other 30 cases were performed with OCBDE ．Operative time，absolute diet days， complications，stone removal rate，an d length of stay of post-operative were observed in both groups．Changes in systolic blood pressure(SBP)，diastolic blood pressure(DBP)，heart rate(HR)，saturation of blood oxygen of the micro—invasive treatment group before，during and after operation were an alyzed．Results In duodenoseope minimally invasive treatment group，twen— ty eight patients were cleared up with stone at the first operation，two patients needed the second because of intubation failale． Micro-invasive treatment group Was superior to the traditional laparotomy group in operative time，absolute diet days，and length of stay of post-operative(P<0．05)．Stone removal rate was 93．33％ in duodenoscope minimally invasive treatmengroup and 96．67％ in traditional laparotomy group，with no statistical significance(P>0．05)．1 case of complication in the micro-invasive treatment group and 8 in the traditional group occurred(P<0．05)．During micro—invasive tremmem．HR in。 creased significantly compared with that of before and after operation ， but there was no significant diference in SpO2，SBP and DBP．Conclusion Duodenoscopy mi nimally invasive treatment is safe and efective and without influence of cardiores。 piratory function，indicating it a8 a optimal treatment for patients with common bile duct stones