【摘要】：研究目的:通過比較常規(guī)器械經(jīng)臍單孔腹腔鏡膽囊切除與三孔法腹腔鏡膽囊切除術(shù)的手術(shù)療效,和自制單孔腹腔鏡手術(shù)操作套筒及手術(shù)技巧改進,探討常規(guī)器械經(jīng)臍單孔腹腔鏡膽囊切除術(shù)的難點與安全性、局限性與可行性、及推廣應(yīng)用價值。研究方法:選擇吉林市中心醫(yī)院肝膽外科自2012年1月至2014年12月的常規(guī)器械經(jīng)臍腹腔鏡膽囊切除術(shù)51例為單孔組(A組),與一時期相同手術(shù)醫(yī)師實行的三孔法腹腔鏡膽囊切除術(shù)50例為對照組(B組),兩組病例病人均為單純膽囊炎或單純膽囊結(jié)石的病人。比較兩組手術(shù)中出血量、手術(shù)操作時間、術(shù)后排氣時間、進食時間,術(shù)后住院時間,住院費用。研究結(jié)果:兩組手術(shù)均按照計劃順利完成,單孔組與對照組相比,手術(shù)出血量無統(tǒng)計學(xué)差異(P0.05),手術(shù)時間對照組少于單孔組,有統(tǒng)計學(xué)意義(P0.05).但在術(shù)后排氣時間,術(shù)后平均住院日,住院費用方面單孔組明顯優(yōu)于對照組(P0.001)。結(jié)論:常規(guī)器械經(jīng)臍單孔腹腔鏡與三孔法腹腔鏡膽囊切除術(shù)相對比,具有術(shù)后疼痛輕、恢復(fù)快、腹部疤痕不明顯且隱蔽等優(yōu)點,是安全可靠的,且由于應(yīng)用了常規(guī)腹腔鏡手術(shù)器械代替專業(yè)的單孔腹腔鏡手術(shù)器械,及以自制的單孔多通道裝置代替市場上昂貴的單孔三通道裝置,極大地減少了手術(shù)成本,這使得單孔腹腔鏡膽囊切除術(shù),擺脫了對專業(yè)單孔手術(shù)器械及單孔三通道裝置的依賴,在我國經(jīng)濟還不十分發(fā)達的現(xiàn)階段,使該術(shù)式具有極強的推廣應(yīng)用價值。
[Abstract]:Objective: to compare the effect of laparoscopic cholecystectomy (LC) with conventional instruments and laparoscopic cholecystectomy (LC) with three-hole laparoscopic cholecystectomy (LC). To discuss the difficulty, safety, limitation and feasibility of laparoscopic cholecystectomy through umbilical single hole, and the value of popularization and application. Methods: from January 2012 to December 2014, 51 cases of laparoscopic cholecystectomy with routine instruments from January 2012 to December 2014 in Jilin City Central Hospital were selected as single hole group (group A). Fifty cases of laparoscopic cholecystectomy with three holes were used as control group (group B) and two groups of patients were patients with simple cholecystitis or simple cholecystolithiasis. The blood loss, operation time, postoperative exhaust time, feeding time, postoperative hospitalization time and hospitalization cost were compared between the two groups. Results: the two groups were successfully completed according to the plan, the single hole group and control group, there was no statistical difference in the amount of operative bleeding (P0.05), the operation time in the control group was less than that in the single hole group, there was statistical significance (P0.05). However, the single hole group was significantly better than the control group in terms of postoperative exhaust time, average hospital stay and hospitalization cost (P0.001). Conclusion: compared with laparoscopic cholecystectomy with three holes, conventional instruments have the advantages of less pain, faster recovery, less visible and concealed abdominal scar and so on, which are safe and reliable. Due to the use of conventional laparoscopic instruments instead of professional single-hole laparoscopic instruments, and the use of self-made single-hole multi-channel devices instead of expensive single-hole three-channel devices on the market, the cost of surgery has been greatly reduced. This makes single-hole laparoscopic cholecystectomy get rid of the dependence on professional single-hole surgical instruments and single-hole three-channel devices. At the present stage when the economy of our country is not very developed the operation has a strong value of popularization and application.
【學(xué)位授予單位】：佳木斯大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R657.4

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