胆道术后残余结石危险因素及对策探讨  

Discussion of risk factors and countermeasures for biliary postoperative residual stones

作　　者：顾元春[1] 

机构地区：[1]淮南市朝阳医院肝胆外科,安徽淮南232007

出　　处：《中国民康医学》2014年第16期15-16,19,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨胆道术后残余结石的危险因素和对应措施。方法:选择行胆道手术后残余结石50例患者为观察组,另外选择同期行胆道手术后无残余结石患者50例为对照组,对两组患者的临床特征进行分析。结果:观察组与对照组患者相比,对患者是否行MRCP/ERCP和单肝叶结石分布检查,是否行急诊手术、进行部分肝切除,是否可以在B超指导下取石等是胆道术后残余结石的主要因素,其差异显著(P<0.05)。经多因素Logistic回归显示,是否进行肝部分切除,行MRCP/ERCP检查、行B超指导取石和胆道镜取石是引发胆道术后残留结石的危险因素,且具有早期警示作用。结论:在行胆道手术时,应在B超指导下、进行MRCP/ERCP检查、肝部分切除、胆道镜等手段的辅助下,起到显著降低术后结石残余的发生率。Objective：To explore risk factors of biliary postoperative residual stones and the corresponding measures. Methods：58 patients with the biliary postoperative residual stones were chosen as observation group,while another 50 cases without the biliary postoperative residual stones during the same period were selected as control group. The clinical features of the two groups were analyzed. Results： For observation group and control group,the main factors for the biliary postoperative residual stones included that whether MRCP /ERCP examination and single lobe stone distribution examination were performed,and whether emergency surgery,partial liver resection,and the stone removing under the guidance of ultrasound were taken,and the differences were significant（ P〈0.05）. The multiple factor logistic regression showed that the risk factors for the biliary postoperative residual stones included partial liver resection,MRCP and ERCP examination,and stone removing under choledochoscope,and they played a role in the early warning.Conclusions： The biliary surgical procedures should be performed in the assistance of the guidance of ultrasound,MRCP /ERCP examination,partial liver resection,choledochoscope and the like,thereby significantly reducing the incidence of the biliary postoperative residual stones.

关 键 词：胆道残余结石 胆道术后 危险因素 预防措施 

分 类 号：R657.42[医药卫生—外科学]