现代方面胆囊结石病与裂孔疝患者合并症的诊断与手术治疗过程

V. Boyko, K. L. Gaft, E. V. Nakonechnyi, T. Z. Aleksandrov, A. Chikin
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摘要

总结。介绍。时至今日,胆石病(GD)与裂孔疝(HH)合并症的及时诊断和手术治疗问题是非常重要和需要重视的。的目标。同时行腹腔镜手术提高GD和HH合并症患者的诊断和手术治疗。材料和方法。主要组16例患者,采用腹腔镜手术治疗GD和HH共病病程。对照组为15例病理相似且在两次就诊期间行腹腔镜手术治疗的患者。这项研究是在GI«V的基础上进行的。T.扎伊采夫IGЕS NAMSU»。研究结果。主组患者同期腹腔镜手术平均时间为(87.5±17.5)min, p<0.05,显著低于对照组(101.2±9.3)min, p<0.05。主组患者总失血量为(45.5±11.1 ml, p< 0.01),对照组患者总失血量为(79.1±5.7)ml, p< 0.01)。主组患者术后疼痛综合征平均强度(根据McGill疼痛问卷)为((3.1±0.8)分,p<0.01),对照组为((7.9±0.7)分,p<0.01)。主组患者术前检查总时间为(1.33±0.5)天,p<0.05;对照组患者术前检查总时间为(3.22±0.65)天,p<0.05。主组平均总暂时丧失工作能力天数不超过(5.5±1.1)天,p<0.05;对照组平均总暂时丧失工作能力天数不超过(11.2±0.6)天,p<0.05。结论。已有研究证明,同时进行腹腔镜手术干预是治疗GD和HH合并症患者的首选方法。此外,研究结果表明,考虑到GD和HH合并的可能性很大,对患者是否存在合并症进行仔细诊断的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MODERN ASPECTS OF DIAGNOSTIC AND SURGICAL TREATMENT OF PATIENTS WITH GALLSTONE DISEASE AND HIATAL HERNIA COMORBID COURSE
Summary. Introduction. As of today, the issue of timely diagnosis and surgical treatment of gallstone disease (GD) and hiatal hernia (HH) comorbid course is extremely relevant and in need of attention. Aim. Improvement of diagnosis and surgical treatment of patients with GD and HH comorbid course by performing simultaneous laparoscopic surgery. Materials and methods. The main group consisted 16 patients, who were treated for the comorbid course of GD and HH by performing simultaneous laparoscopic surgery. The comparison group was made of 15 patients with similar pathologies with laparoscopic surgical treatment during two patients visits to the hospital. The study was carried out on the basis of the GI «V. T. Zaitsev IGЕS NAMSU». Results of the research. The average duration of simultaneous laparoscopic surgery in the main group of patients was ((87.5±17.5) min, p<0.05) and was significantly lower than in the comparison group – ((101.2±9.3) min, p<0, 05). The total volume of blood loss was (45.5±11.1 ml, p<0,01) in the main group of patients, while in the comparison group — ((79.1±5.7) ml, p<0,01). The average intensity of the pain syndrome (according to the McGill pain questionnaire) in the postoperative period in the main group of patients was ((3.1±0.8) points, p<0.01), and in the comparison group – ((7.9±0.7) points, p<0.01). The total duration of preoperative examination of patients in the main group was ((1.33±0.5) days, p<0.05) and in the comparison group — ((3.22±0.65) days, p<0.05). The average total number of temporary incapacity of workdays in the main group did not exceed ((5.5±1.1) days, p<0.05), while in the comparison group — ((11.2±0.6) days, p<0,05). Conclusions. It has been proven that simultaneous laparoscopic surgical intervention is the method of choice for treating patients with GD and HH comorbid course. In addition, the results of the study demonstrate the importance of careful diagnosis of patients for the presence of GD and HH comorbid course, considering of high probability of their combination.
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