肝内胆管结石行肝切除术+T管引流术的疗效与安全性分析  

Efficacy and Safety of Intrahepatic Choledocholithiasis With Hepatectomy and T-tube Drainage

作　　者：胡洪生[1] 

机构地区：[1]湖北医药学院附属东风医院肝胆外科,湖北十堰442008

出　　处：《中国继续医学教育》2017年第8期121-122,共2页China Continuing Medical Education

摘　　要：目的探讨分析肝内胆管结石行肝切除术+T管引流术的疗效与安全性。方法将我院2015年1月—2016年3月收治的71例肝内胆管结石患者根据随机综合序贯法分组,对照组(35例)患者予以单纯胆管切开取石+T管引流术,观察组患者采用肝切除术+T管引流术,统计对比两组患者并发症发生率、残石率等。结果观察组并发症发生率高于对照组,差异有统计学意义(P<0.05);观察组残石率、术后行胆道镜取石次数、术后带T管时间分别为8.3%(3/36)、(1.2±0.5)次、(14.7±5.5)d,均优于对照组37.1%(13/35)、(4.3±1.2)次、(8.4±3.2)d,差异有统计学意义(P<0.05)。结论肝切除是治疗肝内胆管结石的一种重要治疗手段,虽有并发症,但是仍然安全可靠,具有术后结石残留少,术后胆道镜取石次数少,带管时间短等优势,患者生活质量有所提高。Objective To evaluate the efficacy and safety of intrahepatic choledocholithiasis treated with hepatectomy and T-tube drainage. Methods In our hospital from January 2015 to March 2016 a total of 71 cases of hepatolithiasis patients according to the random comprehensive sequential method group, the control group （35 cases） were treated with endoscopic biliary lithotomy ＋T tube drainage, the observation group were treated by hepatic resection ＋T tube drainage, statistical comparison of two groups of patients with complications, the rate of residual stone etc. Results The incidence of complication in the observation group was significantly higher than that in the control group （P〈0.05）. The residual stone rate, the number of choledocholithiasis and the time of T tube were 8.3%（3/36）, （1.2±0.5） times, （14.7±5.5） d, which were better than those in the control group （37.1%,13/35）, （4.3±1.2） times, （8.4±3.2） days, there was difference statistically significance （P〈0.05）. Conclusion Liver resection is an important treatment for the treatment of intrahepatic bile duct stones, although there are complications, but still safe and reliable, with less postoperative residual stones, postoperative choledochoscopy less, with the advantage of short tube time, improve the quality of life of patients.

关 键 词：肝内胆管结石 肝切除术 T管引流术 

分 类 号：R575[医药卫生—消化系统]