肝切除联合纤维胆道镜治疗肝胆结石临床分析  

Clinical Study of hepatectomy with choledochofiberscope in liver gallstones

作　　者：符真[1] 张剑权[1] 符国珍[1] 李志[1] 周帅[1] 

机构地区：[1]海南省海口市人民医院肝胆外科,海南海口570208

出　　处：《海南医学院学报》2017年第13期1812-1814,共3页Journal of Hainan Medical University

基　　金：海南省自然科学基金(817382);海南省科技资助项目(ZDXM2015082)~~

摘　　要：目的:分析肝胆结石实施肝切除联合纤维胆道镜治疗效果,为临床治疗提高参考。方法:选取我院2013年1月~2016年2月收治胆管结石患者96例,随机分为观察组和对照组,两组均实施肝切除配合取石术,观察组联合纤维胆道镜切除术治疗,分析两组治疗效果。结果:观察组手术时间[(3.0±0.6)h]和术中出血量[(386±169)mL]与对照组手术时间[(4.0±0.1)h]和术中出血量[(395±202)mL]差异无统计学意义(P>0.05),观察组手术治疗有效率(89.6%)显著高于对照组(66.7%)。术后并发症包括感染、胆管炎、胆道出血等,两组患者术后并发症发生率差异不明显(P>0.05)。观察组结石残留率(6.3%)和复发率(6.3%)均显著低于对照组结石残留率(22.9%)和复发率(54.2%)。结论:肝胆结石实施肝切除术联合纤维胆道镜治疗明确,安全性高,具有使用价值。Objective：To analyze the clinical study of hepatectomy with choledochofiberscope in liver gallstones,and provide reference for clinical treatment.Methods：A total of 96 patients with liver and gallstones in hospital from January 2013 to February 2016 were selected,patients were randomly divided into observation group and control group.All Patients have taken treatment of choledochofiberscope lithotripsy,observation group patients were given liver lesion resection.The therapeutic effects of the two groups were analyzed.Results：The operation time of the observation group（3.0±0.6）h,intraoperative blood loss of min（386± 169）mL and control group operation time（4.0±0.1）h and intraoperative blood loss of min（395±202）mL,which shows no significant difference（P〉0.05）.The effective rate（89.6%）in the observation group was significantly higher than that in the control group（66.7%）.The postoperative complications included infection,cholangitis,biliary tract bleeding,and two groups of patients with postoperative complication rate were not significantly different.The residual stone rate（6.3%）and recurrence rate（6.3%）in the observation group were significantly lower than those in the control group（22.9%）and the rate of recurrence（54.2%）.Conclusions：Liver and gallbladder stones in the implementation of liver resection and fiber bile duct mirror treatment is of clear,high security,and also of use value.

关 键 词：肝胆结石 纤维胆道镜 肝切除术 复发率 并发症 

分 类 号：R364.25[医药卫生—病理学] R575[医药卫生—基础医学]