胆道镜下钬激光碎石术与液电碎石术治疗难取性肝胆管残余结石的疗效及并发症比较  

Treatment of Bile Duct Refractory Residual Stones: Holmium Laser Lithotripsy vs.Electrohydraulic Shockwave Lithotripsy through Choledochoscopy

作　　者：严骏 

机构地区：[1]重庆市万州区三峡中心医院肝胆外科,重庆市404000

出　　处：《中国激光医学杂志》2015年第2期69-72,共4页Chinese Journal of Laser Medicine & Surgery

摘　　要：目的比较胆道镜下钬激光碎石术与液电碎石术治疗难取性肝胆管残余结石的疗效及并发症。方法回顾性分析2012年06月至2014年5月,行胆道镜下钬激光碎石术的肝胆管结石患者65例的临床资料,同时纳入2010年06月至2012年5月行胆道镜下液电碎石术的肝胆管结石患者58例作为对照组。比较两组患者手术相关指标、疗效及并发症。结果两组患者手术均顺利完成。激光组的手术时间、术中出血量、住院时间均显著低于液电组,差异有显著意义(均P<0.05);但激光组的住院费用显著高于液电组,差异有统计学意义(均P<0.05)。两组患者的碎石成功率、结石取净率及并发症发生例数并无统计学差异(均P>0.05)。结论胆道镜下钬激光碎石术及液电碎石术治疗难取性肝胆管残余结石均安全有效,治疗效果无明显差异。与液电碎石术相比,钬激光碎石术的操作更快、创伤更小,但费用更高。Objective To compare the clinical efficiency and complications of holmium laser lithotripsy and electrohydraulic shockwave lithotripsy through choledochoscopy for the treatment of bile duct refractory residual stones.Methods The clinical data of 65 patients given holmium laser lithotripsy through choledochoscopy from June 2012 to May 2014,and58 patients given eletrohydraulic shockwave lithotripsy through choledochoscopy from June 2010 to May 2012 were reviewed.The indexes related to lithotripsy,efficiency and complications were compared.Results All the patients underwent the lithotripsy successfully.In the laser group,the operation time,blood loss,hospital stay were less than those in the electrohydraulic group（All P〈0.05）,but the hospitalization expense was higher than that in the electrohydraulic group（P〈0.05）.There was no difference in the successful rate of lithotripsy,stone-free rate and complications between the two groups（All P〉0.05）.Conclusions Both holmium laser lithotripsy and electrohydraulic shockwave lithotripsy are safe and effective for the treatment of bile duct refractory residual stones.Compared with electrohydraulic shockwave lithotripsy,holmium laser lithotripsy has less operation time and trauma,but greater expense.

关 键 词：激光 胆道镜 液电 碎石术 残余结石 

分 类 号：R657.4[医药卫生—外科学]