| 张 毅,王 辉,杨林华,王贵阳,李可为.单孔和四孔腹腔镜胆囊切除术的临床疗效对比分析[J].,2022,(7):1248-1251 |
| 单孔和四孔腹腔镜胆囊切除术的临床疗效对比分析 |
| Comparative Analysis of Clinical Efficacy of Single-Port and Four-Port Laparoscopic Cholecystectomy |
| 投稿时间：2021-08-28 修订日期：2021-09-23 |
| DOI：10.13241/j.cnki.pmb.2022.07.011 |
| 中文关键词: 腹腔镜胆囊切除术 单孔腹腔镜 四孔腹腔镜 |
| 英文关键词: Laparoscopic cholecystectomy Single-port laparoscopic cholecystectomy Four-port laparoscopic cholecystectomy |
| 基金项目:上海市科委重点实验室项目(17DZ2260200)；上海申康医院发展中心常见疾病适宜技术研发与推广应用项目(16CR4014A) |
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| 中文摘要: |
| 摘要 目的：探讨单孔和四孔腹腔镜胆囊切除术的疗效差异。方法：回顾性分析上海交通大学医学院附属仁济医院胆胰外科2018年6月至2019年8月期间施行单孔（单孔组）和四孔腹腔镜胆囊切除术（四孔组）的临床资料，包括手术时间、腹腔引流管留置率、手术方案转变率、手术出血量、术后并发症率（胆漏、出血、伤口感染）、住院时间、住院费用、术后24 h镇痛药物使用率和术后满意度等。结果：单孔组手术时间显著长于四孔组[(42.48±6.66)min Vs (32.18±7.08)min]，单孔组腹腔引流管留置率显著低于四孔组（1.67% Vs 21.67%），差异均有统计学意义（P<0.05）；单孔组的住院时间短于四孔组[(2.22±0.65)天 Vs (2.71±0.57)天]，单孔组住院费用高于四孔组[(2.19±0.17)万元Vs (1.81±0.14)万元]，单孔组术后24 h镇痛药物使用率低于四孔组（4.17% Vs 16.67%），术后满意度评分单孔组较四孔组更高[(4.68±0.64)分 Vs (4.47±0.68)分]，差异均有统计学意义（P<0.05）；单孔组的手术出血量、手术方案转变率以及术后并发症与四孔组比较没有差异（P>0.05）。结论：单孔腹腔镜胆囊切除术的术后疼痛轻，恢复快，手术安全性与传统四孔腹腔镜胆囊切除术相比无明显差异，同时单孔腹腔镜胆囊切除术满意度更高，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the difference of efficacy between single-port and four-port laparoscopic cholecystectomy. Methods: A retrospective analysis was performed on the clinical data of laparoscopic cholecystectomy (single-port group) and four-port laparoscopic cholecystectomy (four-port group) performed in the Department of Biliary and Pancreatic Surgery, Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University from June 2018 to August 2019. Including operation time, abdominal drainage tube indwelling rate, surgical plan change rate, surgical blood loss, postoperative complication rate (biliary leakage, bleeding, wound infection), hospital stay, hospitalization cost, use rate of analgesic drugs 24 hours after operation and postoperative satisfaction, etc. Results: The operation time of the single-port group was significantly longer than that of the four-port group [(42.48±6.66)min Vs (32.18±7.08)min], and the abdominal drainage tube indwelling rate in the single-port group was significantly lower than that of the four-port group (1.67% Vs 21.67%), with statistical significance (P<0.05). The hospital stay of the single-port group was shorter than that of the four-port group [(2.22±0.65) days Vs (2.71±0.57)days], the hospitalization cost of the single-port group was higher than that of the four-port group [(2.19±0.17)ten thousand yuan Vs (1.81±0.14) ten thousand yuan], and the use rate of analgesic drugs 24 hours after operation in the single-port group was lower than that of the four-port group (4.17% Vs 16.67%). The postoperative satisfaction score of the single-port group was higher than that of the four-port group[(4.68±0.64)scores Vs (4.47±0.68)scores], and the differences were statistically significant (P<0.05). There were no differences between the single-port group and the four-port group in the surgical blood loss, surgical plan change rate and postoperative complications (P>0.05). Conclusion: Single-port laparoscopic cholecystectomy has light postoperative pain, fast recovery, and no significant difference in surgical safety compared with traditional four-port laparoscopic cholecystectomy. At the same time, single-port laparoscopic cholecystectomy has high satisfaction, which is worthy of clinical promotion. |
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