本文選題：倒刺線 + 腹腔鏡��； 參考：《南昌大學(xué)》2015年碩士論文

【摘要】：研究背景和目的:近年來,伴隨微創(chuàng)技術(shù)的不斷發(fā)展,腹腔鏡膽總管切開取石一期縫合術(shù)(LBEPS)已經(jīng)成為治療膽總管結(jié)石的常用方法,但由于該術(shù)式對腹腔鏡技術(shù)要求高,大大限制了其開展。單向倒刺線是一種新型免打結(jié)可吸收縫合線,可免去手術(shù)中的打結(jié)環(huán)節(jié)以及促進腹腔鏡縫合,目前已在婦產(chǎn)科、泌尿外科證明其有效性,但在普外科方面很少有報道。因此通過對比研究單向倒刺線與普通可吸收線,評價單向倒刺線(V-LOC)在腹腔鏡膽總管切開取石一期縫合術(shù)中的的可行性、安全性以及應(yīng)用效果。方法:回顧性分析我院在2013年1月到2014年12月期間根據(jù)標準選取的55例行腹腔鏡膽總管切開取石一期縫合術(shù)患者,根據(jù)術(shù)中縫合線不同分為:單向倒刺線組(A組,23例),普通可吸收線組(B組,32例)。分別比較兩組術(shù)中情況(手術(shù)時間、術(shù)中出血量)和術(shù)后情況(術(shù)后腸道功能恢復(fù)時間、膽漏發(fā)生率、術(shù)后住院時間以及相關(guān)并發(fā)癥)。采用卡方檢驗分析患者術(shù)前一般資料及術(shù)后并發(fā)癥情況,采用兩樣本比較t檢驗分析手術(shù)時間、術(shù)中出血量、術(shù)后腸道功能恢復(fù)時間、住院時間,使用SPSS 22.0統(tǒng)計軟件進行計算,以α=0.05為檢驗水準。結(jié)果:1、一般情況:兩組病人在年齡分布、性別比例、膽總管直徑、膽總管結(jié)石直徑、膽總管結(jié)石數(shù)目、總膽紅素各項指標之間的差異均無統(tǒng)計學(xué)意義(P0.05);2、術(shù)中情況:兩組病人在手術(shù)時間上差異有統(tǒng)計學(xué)意義,A組的手術(shù)時間明顯少于B組(P0.05),A組和B組在術(shù)中出血量方面差異無統(tǒng)計學(xué)意義(P0.05)。3、術(shù)后情況:兩組在術(shù)后腸道功能恢復(fù)時間、膽漏發(fā)生率、術(shù)后住院時間和其它并發(fā)癥的組間差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1、單向倒刺線在腹腔鏡膽總管切開取石一期縫合中是安全可行的,操作簡便。2、在腹腔鏡膽總管切開取石一期縫合中,單向倒刺線相對于普通可吸收線可以縮短手術(shù)時間,而且具有不增加膽漏發(fā)生率以及其它并發(fā)癥等特點。
[Abstract]:Background and purpose: in recent years, with the continuous development of minimally invasive techniques, laparoscopic choledochotomy and primary stony suture (LBEPS) has become a common method for the treatment of choledocholithiasis. However, because of its high requirements for the laparoscopic technique, it has greatly restricted its development. The single reverse thread is a new type of non knot absorbable suture. In order to avoid the knot in the operation and promote the laparoscopic suture, it is now in the obstetrics and Gynecology, and the Department of Urology has proved its effectiveness, but there are few reports in the Department of general surgery. So by comparing the unidirectional and common absorbable lines, the V-LOC in the first stage suture of the laparoscopic choledochotomy is evaluated. Methods: a retrospective analysis of 55 cases of laparoscopic choledochotomy for primary suture from January 2013 to December 2014, according to the standard, was divided into one way (group A, 23 cases), common absorbable line group (group B, 32 cases). The two groups were compared. Cases (operation time, intraoperative bleeding volume) and postoperative conditions (postoperative recovery time of intestinal function, incidence of bile leakage, postoperative hospitalization time and related complications). The general data and postoperative complications were analyzed by chi square test, and two samples were used to compare the operation time, intraoperative bleeding and postoperative intestinal function by t test. Recovery time and hospitalization time were calculated with SPSS 22 statistical software, and alpha =0.05 was used as the test level. Results: 1, general situation: the two groups of patients were in age distribution, sex ratio, choledocholithiasis diameter, choledocholithiasis diameter, choledocholithiasis number and total bilirubin indexes, no statistical significance (P0.05); 2, intraoperative conditions: There was significant difference in the operation time between the two groups. The operation time of group A was significantly less than that of group B (P0.05). There was no significant difference between group A and B in the intraoperative bleeding (P0.05).3. The postoperative situation: the recovery time of intestinal function, the incidence of bile leakage, the time of postoperative hospitalization and other complications were not statistically significant. Significance (P0.05). Conclusion: 1, the unidirectional barb line is safe and feasible in the primary suture of laparoscopic choledochotomy, and it is easy to operate.2. In the first stage suture of the laparoscopic choledochotomy, the unidirectional barbed wire can shorten the operation time compared with the common absorbable line, and there is no increase in the incidence of bile leakage and other complications. Point.

【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R657.4

【引證文獻】

相關(guān)期刊論文 前1條

1 鄭偉;張云;;老年膽總管結(jié)石患者腹腔鏡膽總管探查術(shù)后一期縫合與T管引流療效比較[J];世界華人消化雜志;2017年01期

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本文編號：1854625