微创保胆取石术联合中药胆道排石汤治疗胆囊结石临床观察  

Clinical Observation on Treatment of Gallbladder Stones with Minimally Invasive and Chinese Medicine Biliary Excretion Stone Decoction

作　　者：姚本来 

机构地区：[1]海南省三亚市人民医院,海南三亚572000

出　　处：《中国中医急症》2016年第5期897-899,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：海南省科技计划项目(H20130529-21)

摘　　要：目的观察微创保胆取石术联合中药胆道排石汤治疗胆囊结石的临床疗效,评价微创保胆取石术联合胆道排石汤治疗胆囊结石的临床价值、安全性及可行性。方法 64例患者采用随机单盲方法随机分为研究组和对照组各32例。对照组仅行微创保胆取石术。研究组除行微创保胆取石术外,再予口服中药胆道排石汤。术后观察胃肠功能恢复时间、腹泻发生率、治疗前后胆囊收缩功能、胆囊壁厚度、胆瘘及术后结石发生率,并对组间数据进行统计学分析,进而作出安全性及临床疗效评价。结果研究组胃肠功能恢复时间优于对照组(P<0.05)。研究组并发症腹泻发生率低于对照组(P<0.05)。两组治疗后胆囊壁厚度及收缩功能均较治疗前改善(均P<0.05),且研究组优于对照组(均P<0.05)。研究组结石复发率低于对照组(P<0.05)。纳入64例患者临床依从性尚可,均在规定时间内完成本研究,研究过程中未出现脏器受损等不良事件。结论微创保胆取石术联合胆道排石汤治疗胆囊结石较单纯微创保胆取石术,术后胃肠功能恢复较快,且可降低胆囊壁厚度、增强胆囊收缩功能、有效降低腹泻发生率和结石复发率。但在预防术后胆瘘发生率上无明显作用。Objective： To observe the clinical curative effect of minimally invasive gallbladder stone and Chinese medicine treatment of gallbladder stone,and to evaluate the clinical value,safety and feasibility of minimally invasive gallbladder stone combined with bile duct stone removal. Methods： 64 patients with gallbladder stones from January 2012 to November 2014 in our hospital were enrolled. The patients were randomly divided into the study group and the control group by random single blind method,32 cases in each. The control group only underwent minimally invasive gallbladder stone removal. The study group,apart from minimally invasive cholecystolithotomy,took extra oral administration of traditional Chinese medicine. The recovery time of gastrointestinal function,the incidence of diarrhea,gallbladder contraction function,gallbladder wall thickness,bile leakage and postoperative stones were observed,and the data were statistically analyzed. Results： The study group was significantly better than the control group in promoting postoperative recovery of gastrointestinal function. The incidence of diarrhea in the study group was significantly lower than that in the control group. The gallbladder contraction function in the study group and the control group were significantly enhanced. In the study,the thickness of the gallbladder wall was decreased slightly,while the thickness of the gallbladder wall was decreased significantly in the study group before and after treatment. The incidence of biliary fistula after surgery was not statistically signif-icant compared with the control group. The recurrence rate of stones in the study group was significantly lower than that in the control group. Conclusion： Minimally invasive gallbladder stone removal with bile duct stones in the treatment of gallbladder stone is relatively simple and minimally invasive gallbladder stone removal,postoperative gastrointestinal function recovery,and can reduce the gallbladder wall thickness,enhance gallbladder contraction function,effe

关 键 词：胆囊结石 微创保胆取石术 胆道排石汤 临床疗效 

分 类 号：R575.62[医药卫生—消化系统]