牛磺熊去氧胆酸预防肝胆管结石术后复发的随机对照研究  

A Randomized Controlled Study on Tauroursodeoxycholic Acid for the Prevention of Postoperative Relapse of Hepatic Calculus

作　　者：肖震宇[1] 杨藩[1] 童兵[1] 黄志勇[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院普外科,武汉430030

出　　处：《中国微创外科杂志》2015年第10期891-893,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨肝胆管结石手术后口服牛磺熊去氧胆酸（tauroursodeoxycholic acid ，TUDCA）预防结石复发的有效性及临床价值。方法我院2010年1月～2012年1月90例手术治疗的肝胆管结石患者，术后采用完全随机化分组法分为2组，每组45例。TUDCA 组口服 TUDCA（500 mg，每天1次，每月连续服用5天后停药25天，治疗期为2年），对照组不服药。2组随访方法相同，比较术后2年肝胆管结石复发率和因结石复发的再手术率。结果术后2年 TUDCA 组胆管结石复发率为6．7％（3／45），对照组为26．7％（12／45）（χ2＝6．480，P ＝0．011）；TUDCA 组再手术率为2．2％（1／45），对照组为20．0％（9／45）（χ2＝7．200，P ＝0．007）。结论肝胆管结石手术后口服牛磺熊去氧胆酸能够有效预防胆管结石的复发。Objective To study the efficacy and application value of tauroursodeoxycholic acid（TUDCA）for the prevention of postoperative relapse of hepatic calculus. Methods A total of 90 hepatic calculus patients surgically treated in our hospital were divided into two groups randomly,with 45 patients in each group.The patients in the therapeutic group were given TUDCA after surgery for two years （500 mg /day for 5 days every month）,whereas the patients in the control group received the same nursing and diet therapies without medication.Both groups were followed up for 2 years.The statistics of the relapse rate of hepatic calculus and reoperation rate were conducted,and the comparison between the two groups was performed. Results There was significant difference between the therapeutic group and the control group at two years after surgery in terms of the relapse rate of hepatic calculus [6.7% （3 /45）vs.26.7% （12 /45）,χ2 =6.480,P =0.01 1 ]and reoperation rate [2.2% （1 /45 ）vs.20.0% （9 /45 ）,χ2 =7.200,P =0.007]. Conclusion The application of TUDCA in patients after hepatic calculus surgery can prevent the relapse of hepatic stones.

关 键 词：肝胆管结石 术后复发 牛磺熊去氧胆酸 

分 类 号：R657.4[医药卫生—外科学]