ERCP及EST联合LC治疗胆总管结石的效果观察及对患者预后的影响  

Effect of ERCP and EST combined with LC in the treatment of common bile duct stones and its influence on prognosis

作　　者：郑纪虎[1] Zheng Jihu(Department of Hepatobiliary Surgery,Changshu No.2 people＇s Hospital,Suzhou,Jiangsu,215500,China)

机构地区：[1]江苏省苏州市常熟市第二人民医院肝胆外科,江苏苏州215500

出　　处：《当代医学》2018年第28期23-25,共3页Contemporary Medicine

摘　　要：目的探究内窥镜逆行胰腺胆总管造影术(ERCP)/内窥镜下切开括约肌术(EST)联合腹腔镜胆囊切除术(LC)治疗胆总管结石的效果及对患者预后的影响。方法回顾性分析128例受试者均为2016年3月~2018年3月本院肝胆外科收治的胆总管结石患者的临床资料,按照手术方法的不同分为观察组(76例,行ERCP/EST联合LC治疗)和对照组(52例,行传统开腹手术治疗)。对比观察两组患者住院时间、肛门排气时间、术后禁食时间及术后1天患者血清白细胞介素-6(IL-6)、C反应蛋白(CRP)等炎性因子水平,同时对比分析两组患者术后并发症发生情况及结石残留率、复发率。结果观察组患者住院时间、肛门排气时间及术后禁食时间均明显短于对照组,且术后1天血清IL-6、CRP水平均明显低于对照组;观察组患者并发生发生率(3.94%)明显低于对照组(11.54%),差异均具有统计学意义(P<0.05)。两组残留结石率及结石复发率均分别相近,差异无统计学意义。结论 ERCP/EST联合LC治疗胆总管结石效果显著,能显著缩短患者住院时间,降低术后患者体内炎症反应程度,同时可明显改善患者预后。Objective To investigate the effect of ERCP/EST combined with LC in the treatment of common bile duct stones and its impact onprognosis. Methods According to the different surgical methods, patients with common bile duct stones admitted to our hospital from March 2016to March 2018 were divided into observation group （76 cases, ERCP/EST combined with LC treatment） and control group （52 cases, traditional opensurgery）. The hospitalization time, anal exhaust time, postoperative fasting time and serum IL-6 and CRP levels in the two groups were compared. Atthe same time, the postoperative complications, stone residual rate and recurrence rate were compared between the two groups. Results The hospitalizationtime, anal exhaust time and postoperative fasting time of the observation group were significantly shorter than the control group, and the serumIL-6 and CRP levels of the observation group were significantly lower than the control group on the 1st postoperative day, the incidence ofpatients in the observation group （3.94%） was significantly lower than that in the control group （11.54%）, and the difference were statisticallysignificant （P〈0.05）. The residual stone rate and stone recurrence rate were similar in the two groups, and there was no significant difference.Conclusion ERCP/EST combined with LC in the treatment of common bile duct stones is significant, can significantly shorten the length of hospitalstay, reduce the degree of inflammatory response in patients after surgery, and can significantly improve the prognosis of patients.

关 键 词：胆总管结石 内窥镜逆行胰腺胆总管造影术 内窥镜下切开括约肌术 腹腔镜胆囊切除术 预后 

分 类 号：R657.4[医药卫生—外科学]