胆道镜联合钬激光与液电碎石治疗肝内外胆管多发结石比较  

Treatment of Intrahepatic and Extrahepatic Bile Duct Stones with Choledochoscopy Combined with Holmium Laser and Electro-hydraulic Lithotripsy

作　　者：廖广宇 

机构地区：[1]龙岩人民医院,福建龙岩364000

出　　处：《中外医学研究》2017年第29期5-7,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析胆道镜联合钬激光碎石治疗肝内外胆管难取性结石的效果。方法:将2015年1月-2016年1月在笔者所在医院就诊的98例肝内外胆管难取性结石患者按照数字随机表法分为对照组和试验组;对照组在胆道镜引导下行液电碎石治疗,试验组在胆道镜引导下行激光碎石治疗;对比分析两组患者手术过程、碎石率、术后并发症等。结果:试验组患者术中出血量(16.5±7.0)ml、手术时间(29.1±8.9)min及住院时间(4.6±2.3)d,均显著小于对照组,差异有统计学意义(P<0.05)。两组患者碎石成功率、结石取净率和再次手术率比较差异无统计学意义(P>0.05)。对照组患者术后并发症发生率(12.24%),显著高于试验组(2.04%),差异有统计学意义(P<0.05);对照组术后1年复发率(6.12%)与试验组(4.08%)比较差异无统计学意义(P>0.05)。结论:在胆道镜引导下,液电碎石技术与钬激光碎石技术均获得了较优的治疗效果,但钬激光碎石技术创伤小、恢复快、并发症发生风险低,具有推广应用价值。Objective： To analyze the application of choledochoscopy combined with holmium laser lithotripsy in the treatment of intrahepatic and extrahepatic bile duct refractory stones.Method： From January 2015 to January 2016, 98 cases of intrahepatic and extrahepatic bile duct refractory stones were randomly divided into the control group and the experimental group according to the random number method.The control group was treated with choledochoscopy.The experimental group was treated with laser lithotripsy under the guidance of choledochoscopy.The operative procedure, gravel rate and postoperative complications were analyzed.Result： The intraoperative blood loss （16.5 ± 7.0）ml, operation time （29.1 ± 8.9）min and hospital stay （4.6 ± 2.3）d in the experimental group, which were significantly lower than those in the control group（P〈0.05）.There was no significant difference in gravitational success rate, stone removal rate and reoperation rate between the two groups（P〉0.05）.The incidence of postoperative complications in the control group（12.24%） was significantly higher than that iri the experimental group（2.04%）, the difference was significant（P〈0.05）; the recurrence rate in the control group（6.12%） was not significant than 4.08% in the experimental group（P〉0.05）.Conehlsion： Under the guidance of eholedoehoscopy, fluidized lithotripsy and holmium laser lithotripsy have obtained better therapeutic effect, but holmium laser lithotripsy is less traumatic, quick recovery, low risk of complieations, and has popular application value.

关 键 词：肝内外胆管难取性结石 胆道镜 钬激光碎石 液电碎石 

分 类 号：R657.42[医药卫生—外科学]