腹腔镜下胆道镜联合等离子碎石术与传统开腹术式治疗肝内胆管结石的疗效比较  

Effect comparison between laparoscopic combination therapy of choledochoscope and plasma lithotripsy and conventional open surgical therapy in treatment of patients with hepatolithiasis

作　　者：张福鑫[1] 

机构地区：[1]四川省攀枝花学院附属医院,四川攀枝花617000

出　　处：《实用临床医药杂志》2014年第7期58-61,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨腹腔镜下胆道镜联合等离子碎石术治疗肝内胆管结石的疗效与安全性。方法将腹腔镜下胆道镜联合等离子碎石术治疗的28例肝内胆管结石患者设为观察组,另将同期收治的28例接受开腹手术治疗的肝内胆管结石患者设为对照组。比较2组患者主要围术期指标、术后T管监测指标及结石取尽率。结果观察组患者术中出血量、术后排气时间及住院时间均明显短于对照组,差异有统计学意义(P<0.05);观察组患者在术后第3天起,T管引流量及胆管压力均显著小于对照组,差异有统计学意义(P<0.05);观察组结石取尽率为92.86%,明显高于对照组的78.57%,差异有统计学意义(P<0.05)。结论腹腔镜下胆道镜联合等离子碎石术治疗肝内胆管结石具有直观、微创、残石率低及安全等优点,值得临床推广应用。Objective To explore the efficacy and safety of laparoscopic combination therapy of choledochoscope and plasma lithotripsy in treatment d patients with hepatolithiasis. Methods 28 hepatolithiasis patients treated with laparoscopic combination therapy of choledochoscope and plasma lithotripsy were collected and designed as observation group, and 28 28 hepatolithiasis patients treated with open surgical therapy were collected and designed as control group. The major perioperative and postoperative Ttube monitoring indicators as well as residual stone rate were compared between two groups. Results The blood loss, postoperative exhaust time and hospital stay in the observation group were significantly less and shorter than those in the control group （P 〈0.05）. The Ttube drainage and duct pressure in the observation group from the third day after operation were significantly less than the control group （P 〈 0.05）. Residual stone rate in observation group was 92.86 %, which was significantly higher than 78.57 % in the control group （P 〈 O. 05 ）. Conclusion Laparoscopic combination therapy of choledochoscope and plasma lithotripsy shows a series of advantages such as intuitive, minimally invasive, low residual stone rate and safety in treatment of hepatolithiasis, so it is worthy of clinical application and popularization.

关 键 词：胆管结石 腹腔镜 胆道镜 等离子碎石 

分 类 号：R364.2[医药卫生—病理学]