腹腔镜胆总管探查一期缝合后血清肝功能变化的临床研究  

The Clinical Study of Serum Liver Function Changes after Laparoscopic Choledochotomy with Primary Suture

作　　者：索运生[1] 张明哲[1] 尹思能[1] 肖宏[1] 陈先林[1] 易斌[1] 李涛[1] 

机构地区：[1]四川省成都市第二人民医院肝胆胰外科,四川成都610017

出　　处：《华西医学》2006年第2期231-233,共3页West China Medical Journal

摘　　要：目的：通过临床试验，比较分析腹腔镜胆总管探查取石一期缝合胆总管和T管引流后肝功能的变化，为腹腔镜胆总管探查胆管一期缝合术的可行性提供理论及试验依据。方法：采用前瞻性随机对照研究的方法，分析比较2003年8月～2004年1月30例腹腔镜胆总管探查取石病人术后肝功能的变化，其中一期缝合15例，T管引流15例。结果：血清肝功能测定：一期缝合组各时间点血清ALT、AST、TBIL、DBIL、ALP含量均有所下降，某些时间点有显著性差异（P〈0．01），而T管引流组各时间点血清ALT、AST、TBIL、DBIL无显著性差异（均P〉0．05）。两组间比较一期缝合组ALT、AST、TBIL DBIL在某些时间点较T管引流组显著性下降（P〈0．05），但血清ALP含量，两组之间各时间点均无显著性差异（均P〉0．05）。结论：腹腔镜胆总管探查取石后一期缝合与T管引流比较，有利于损害之肝功能迅速恢复且减黄效果与T管引流术相同或相近。Objective： To investigate serum liver ihnction changes after Laparoscopie common bile duct exploration and provide theoretical or experimental evidence for this operation procedure. Methods： This randomized prospective study compared the primary closure versus T- tube drainage of the common bile duct following laparoscopic exploration for calculus disease. Between August 2003 and January 2004. 30 patients underwent these procedures for CBD stone. Fifteen patients underwent primary closure and the other fifteen underwent T- tube. dininage. Results： （ 1 ） The serum liver function vohune was examined： ALT, AST, TBIL, DBIL, ALP volume in ],BEPS group were all decreased at 1, 3, 5, postoperative day and at some time points, the decrease was significant （ P 〈 0.01 ）. however the ALT, AST, TBIL, DBIL and ALP volume in LCTD group were not significantly different at all time points. The ALT, AST, TBIL, DBIL in LBEPS group were significantly lower than those in LCrD group at some time points （ P 〈 0.05）. But Alp volume showed no statistical deffrence between the two groups. Conclusion： The damaged liver function was restored quickly after laparoscopic procedure. The effect of decreasing jaundice in LBEPS group was apparently better than that in LCTD group.

关 键 词：胆总管结石/外科学 腹腔镜胆总管切开取石 前瞻性半随机对照研究 一期缝合 

分 类 号：R657.4[医药卫生—外科学]