精准肝切除在肝胆管结石病中的临床应用  

Clinical Application of Precise Hepatectomy in Treatment of Hepatolithiasis

作　　者：胡秋灵[1] 淦勤 

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2014年第14期53-55,共3页Medical Innovation of China

摘　　要：目的:探讨精准肝切除术在肝胆管结石病中的临床应用价值。方法:选取2008年6月-2013年6月本院收治的128例肝内胆管结石病患者,采用前瞻性、非随机对照临床试验方法分为精准肝切除组(68例)和非规则性肝切除组(60例),比较两组患者的手术时间、术中出血量、术后并发症、住院时间、结石清除率和结石复发情况。结果:精准肝切除组术中出血量、ALT峰值、AST峰值、TBIL峰值及住院时间均优于非规则性肝切除组,精准肝切除组术后结石残留率、并发症发生率及复发率(8.8%、11.8%、5.9%)均明显低于非规则性肝切除组(21.7%、23.3%、16.7%),比较差异有统计学意义(P<0.05)。结论:精准肝切除治疗肝胆管结石病疗效确切,可缩短患者康复周期,降低术后结石残留率及并发症发生率,减少复发。Objective： To explore the clinical value of precise hepatectomy in treatment of hepatolithiasis. Method： 128 patients with hepatolithiasis admitted into this hospital from Jun., 2008 to Jun., 2013 who were recruited, and they were assigned into 2 groups in this prospective, non-randomized controlled clinical trial： precise hepatectomy group （ n=68 ） and irregular hepatectomy group （ n=60 ） . The operative time, blood loss, postoperative complications, length of stay, stone clearance rate, and stones recurrence between both groups were compared. Result： The blood loss, ALT peak, AST peak, TBIL peak, and length of stay in precise hepatectomy group wer~ better than those in irregular hepatectomy group. The stone residual rate, incidence of complications, and recurrence rate in precise hepatectomy group （ 8.8%, 11.8%, 5.9% ） were lower than those in irregular hepatectomy group （ 21.7%, 23.3%, 16.7% ）. Conclusion： The precision hepatectomy for the treatment of hepatolithiasis has definite efficacy, and can shorten the patient rehabilitation period and reduce postoperative stone residual rate and incidence of complications, recurrence.

关 键 词：肝胆管结石病 精准肝切除 非规则性肝切除 临床效果 结石清除率 

分 类 号：R657.3[医药卫生—外科学]