LBEPS及OCTD治疗胆总管结石术后效果观察及护理

目的]探讨胆总管结石不同手术方法治疗后的效果与护理要点。方法]随机抽取同期腹腔镜胆总管探查取石术一期缝合胆管病人60例(即LBEPS组为Ⅰ组)、开腹胆总管切开取石术病人60例(即OCTD组为Ⅱ组),两组在术后胃肠功能恢复时间、舒适度评估、术后胆漏、住院费用、住院天数方面进行比较。结果]住院时间、术后胃肠功能恢复时间两组比较差异有统计学意义(P<0.05);住院费用、胆漏发生率两组差异无统计学意义(P>0.05)。在腹胀腹痛、切口疼痛、排尿困难、活动不便等舒适度方面,Ⅰ组发生率明显低于Ⅱ组。结论]双镜联合下胆总管切开取石一期缝合术较经典开腹胆总管切开取石T管引流术对病人创伤小,恢复快,住院时间短、并发症少。

Observation on postoperative effect of LBEPS and OCTD treatment for common bile duct stones and nursing care of it

Objective： To probe into the effect of different surgical methods in the treatment of patients with common bile duct stones and its care points. Methods： 60 cases of patients with primary suture after same period in laparoscopic common bile duct exploration surgery were randomly selected as LBEPS group（group I ）and taking 60 cases undergoing laparotomy eholedocholithotomy surgery as OCTD group for group II , then to compare the postoperative recovery time of gastrointestinal function, comfort assessment, postoperative biliary leakage, hospitalization costs, length of hospital stay. Results：There were statistically significant differences in hospitalization days, postoperative gastrointestinal function recovery time between group I and group II （P（0. 05） ;hospitalization expenses, incidence of bile leakage between two groups had not been found any significant differences （P〉0.05）. Group I had significantly lower incidence in abdominal pain, bloating, incision pain, difficulty urinating, activity inconvenience compared with group II. Conclusion： Compared with classic open choledocholithotomy T tube drainage, the choledocholithotomy a suture under combination of double scopes has smaller trauma for patients, and the trauma recovery is quicker, hospital stay of the patients is shorter, with fewer complications. And it is economy, comfortable and safe for patients, the surgery greatly reduced the nursing workload, then to allow nurses to have sufficient time to provide high quality and efficient service for patients.