纤维胆道镜治疗肝胆管结石合并肝门部胆管狭窄的疗效  

Clinical Observation of Efficacy in Treatment of Hepatolithiasis Accompanied with Bile Stricture Near Porta Hepatis by Choledochofiberscope

作　　者：赵铁彦[1] 赵华[1] 樊晨[1] 陈文斌[1] 院存珍[1] 

机构地区：[1]解放军264医院普通外科,太原030001

出　　处：《中国医药导刊》2014年第3期401-402,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨纤维胆道镜在肝胆管结石合并肝门部胆管狭窄术中和术后应用的合理性。方法:将76例肝胆管结石合并肝门部胆管狭窄患者随机分为两组,Ⅰ组38例术中配合应用纤维胆道镜治疗,Ⅱ组38例术后应用纤维胆道镜治疗,比较两组残石率及Ⅰ组术中纤维胆道镜结石取净率与Ⅱ组术后纤维胆道镜取净率。结果:Ⅰ组术后有3例患者残余结石,残石率为7.9%,Ⅱ组术后有5例患者残余结石,残石率为13.2%,两组差异有统计学意义(P<0.05);Ⅰ组术中纤维胆道镜结石取净率为85.7%,Ⅱ组术后纤维胆道镜取净率为58.8%,两者差异有统计学意义(P<0.05)。结论:肝胆管结石术中或术后应用纤维胆道镜有助于降低残石率,提高治疗效果,有广阔的临床应用前景。Objective：To study the clinical application of choledochofiberscope in the treatment of hepatolithiasis accompanied with bile stricture near porta hepatis and its rationality. Methods：76 cases of patients with hepatolithiasis accompanied with bile stricture near porta hepatis were divided into two groups. The patients of Ⅰgroup were with the application choledochofiberscope treatment intraoperation. The patients of Ⅱgroup were with the application choledochofiberscope treatment postoperation. Results：The residual stone rate operation in patients with hepatolithiasis accompanied with bile stricture near porta hepatis performed intraoperation and postoperation choledochofiberscope were 7.9%and 13.2%, and the difference between the two groups was statistically significant （P〈0.05）. The removal rate of operation in patients with hepatolithiasis accompanied with bile stricture near porta hepatis performed intraoperation and postoperation choledochofiberscope were 85.7%and 58.8%, and the difference between the two groups was statistically significant （P〈0.05）. Conclusions：Operation combined with stone removal by cholangioscopy can lower the residual stone rate of intraoperation and postoperation. It has excellent therapeutic effects and deserves further dissemination.

关 键 词：纤维胆道镜 肝胆管结石 狭窄 

分 类 号：R657.4[医药卫生—外科学]