X线与B超定位肝内胆管结石行体外震波碎石的对比研究  

Comparative study of X-ray and B-ultrasound localization of intrahepatic biliary stone in extracorporeal shock wave lithotripsy

作　　者：刘鄂长[1] 林秀云[1] 唐华[2] 杨生旭[3] 董常友 林海[1] 路中江[1] 苏连珠[1] 

机构地区：[1] 福建省三明市第二医院普外科,三明366000 [2] 福建省三明市第二医院泌尿外科,三明366000 [3] 福建省三明市第二医院B超室,三明366000 [4] 福建省三明市第二医院设备科,三明366000

出　　处：《国际外科学杂志》2014年第10期682-684,共3页International Journal of Surgery

基　　金：福建省三明市科技计划项目[No.2007-L-13（1）]的子项目

摘　　要：目的 对比研究肝内胆管结石行体外震波碎石X线与B超定位的准确率.方法 对2007年12月-2013年10月,由福建省三明市第二医院收治的120例经T管造影证实有肝内胆管嵌顿结石患者前瞻性、采用随机数字表法分组,分别采用经T管插入一气囊导尿管阻塞胆总管注入造影剂X线定位（以下简称X线组）和B超定位（以下简称B超组）的方法,固定的碎石能量只针对一个结石进行体外震波碎石,碎石后经胆道镜探查,有无碎成3块以上作为判断定位的准确与否,比较两种定位方法的准确率.结果 X线组定位的准确率（100.0％）明显高于B超组（88.3％）,差别有统计学意义（Fisher确切概率法,P=0.013）.结论 为了配合胆道镜取石的肝内胆管结石体外震波碎石术,改进后的T管造影X线定位,可以达到精准的碎石定位,满足胆道镜套取肝内嵌顿结石的需要,同时操作简单易行容易推广.Objective To compare the accuracy of intrahepatic biliary stone of X-ray and B-ultrasound localization in extracorporeal shock wave lithotripsy.Methods From Dec.2007 to Oct.2013,120 cases with intrahepatic biliary impacted stone patients confirmed by T tube cholangiography were prospectively and randomly grouped,and two methods were respectively adopted.One is that T-tube was inserted into the air sac urinary catheter and then the intrahepatic bile duct X-ray localization was injected （referred as X-ray group） ; The other is B-ultrasound localization （referred as B-ultrasound group）.Fixed lithotripsy energy was only suitable for an impacted stone by extracorporeal shock wave lithotripsy.Using the choledochoscopy,the accuracy can be confirmed if the amount of breakstone were more than 3.Based on the results mentioned above,the accuracy rating of two fixed methods can be confirmed.Results It was found that the accuracy rating of the X-ray group was much higher than that of B-ultrasound group and the difference between two methods was also statistically significant （Fisher exact propability test,P =0.013）.Conclusions The extracorporeal shock wave lithotripsy in order to cope with choledochoscope extract the intrahepatic biliary impacted stone,the improved T-tube cholangiography X-ray localization,can achieve precise localization of the stone,satisfy the need of choledochoscope extract the intrahepatic biliary impacted stone,at the same time,simple operation and easy popularization.

关 键 词：碎石术 胆结石 X线 定位 B超定位 

分 类 号：R657.3[医药卫生—外科学]