腹膜后入路小切口手术与经皮肾镜治疗胰腺坏死感染的对比研究

摘要

目的 探讨腹膜后入路小切口手术治疗胰腺坏死感染与经皮肾镜治疗胰腺坏死感染的疗效.方法 腹膜后入路小切口手术治疗胰腺坏死感染74例,经皮肾镜治疗胰腺坏死感染20例.比较两种方法的手术时间、平均住院时间、再次手术次数、平均住院费用、术后抗生素使用时间及术后第7天白细胞计数.结果 腹膜后入路小切口手术组与经皮肾镜手术组的手术时间分别为(85.15±10.59)分钟、(110.84±20.34)分钟;平均住院时间分别为(38.08 ±4.25)天、(41.54±5.39)天;再次手术分别为6例、5例;平均住院费用分别为(71763.25±295.39)元、(83979.60±234.52)元;术后抗生素使用时间分别为(6.1±2.2)天、(7.3±2.0)天;术后第7天白细胞数分别为(6.9±1.5)×109/L、(8.1±1.9)×109/L.两组比较差异有统计学意义(P＜0.05).结论 腹膜后入路小切口手术治疗胰腺坏死感染较经皮肾镜治疗胰腺坏死感染更确切,疗效更佳.%Objective To investigate the clinical efficacy of retroperitoneal pancreatic necrosectomy using small incision and percutaneous nephroscope.Meheods Seventy-four patients received retroperitoneal pancreatic necrosectomy using small incision and twenty patients received retroperitoneal pancreatic necrosectomy using percutaneous nephroscope in our hospital were enrolled from March 2006 to June 2016.The operation time,average hospitalization time,number of reoperations,average hospital expenses,postoperative antibiotic use,and white blood cell count at 7 days after surgery of the two groups were recorded and analyzed.Results The small incision group took less operation time(85.15 ± 10.59 mins) than the percutaneous nephroscope group (110.84 ± 20.34 mains).In addition,it is superior to the percutaneous nephroscope group in average hospitalization time(38.08 ± 4.25 and 41.54 ± 5.39 days,respectively),number of reoperations (6 and 5 cases,respectively),the average of hospitalization expenses (71763.25 ±295.39 and 83979.60 ±234.52 YUAN),postoperative antibiotic use(6.1 ±2.2 and 7.3 ±2.0 days,respectively)and white blood cell count at 7 days after surgery[(6.9 ± 1.5) × 109/L and(8.1 ± 1.9) × 109/L,respectively].The difference was statistically significant(P ＜0.05).Conclusion In the operation of retroperitoneal pancreatic necrosectomy,retroperitoneal approach through small incision is superior to percutaneous nephroscope.