不同术式治疗肝胆管结石合并胆管狭窄的临床疗效对比分析  

Comparative Analysis of Different Surgical Methods in the Treatment of Hepatolithiasis With Bile Duct Stricture

作　　者：陈智敏[1] 汪昱[1] 徐建明[1] 李海[1] 赵盺波 CHEN Zhimin;WANG Yu;XU Jianming;LI Hai;ZHAO Xinbo(Department of Hepatobiliary Surgery,Chongzhou People＇s Hospital,Chongzhou Sichuan 611230,China)

机构地区：[1]崇州市人民医院肝胆外科,四川崇州611230

出　　处：《中国继续医学教育》2018年第32期102-104,共3页China Continuing Medical Education

摘　　要：目的比较不同手术方式治疗肝胆管结石合并胆管狭窄的临床疗效。方法选取2014年1月—2016年1月崇州市人民医院肝胆外科诊治的60例肝胆管结石合并胆管狭窄患者作为研究对象。将其随机分为对照组和观察组,每组均为30例。观察组采用肝叶切除术治疗,对照组采用非肝叶切除术,术后随访两年,比较两组患者的治疗有效率、残石率、复发率以及肝功能等指标。结果结果显示,观察组的治疗总有效率为93.33%,对照组的治疗总有效率为73.33%,经χ2检验,两组比较,差异具有统计学意义(P <0.05);观察组的术后残石率(3.33%)、复发率(6.67%)均低于对照组的残石率(20.00%)和复发率(26.67%),经χ~2检验,两组比较,差异均具有统计学意义(P <0.05);治疗前,两组患者ALT、AST、ALP等肝功能指标比较,差异无统计学意义(P> 0.05),治疗后,两组患者ALT、AST、ALP等肝功能指标均显著降低,与治疗前相比,差异均具有统计学意义(P <0.05),且治疗后观察组的ALT、AST、ALP均低于对照组,差异均具有统计学意义(P <0.05)。结论对于肝胆管结石合并胆管狭窄的患者,采用肝叶切除术疗效优于非肝侧叶切除术,同时可以改善患者肝功能指标,降低术后患者残石率和复发率。Objective To compare the clinical effects of different surgical methods in the treatment of hepatolithiasis with bile duct stricture. Methods 60 cases of hepatolithiasis with bile duct stricture were selected from January 2014 to January 2016 in the department of hepatobiliary surgery of Chongzhou people＇s hospital. The patients were randomly divided into control group and observation group, 30 cases in each group. The observation group was treated with hepatic lobectomy, and the control group was treated with non hepatic lobectomy. All patients were followed up for two years. The effective rate, residual stone rate, recurrence rate and liver function were compared between the two groups. Results The results showed that the total effective rate was 93.33% in the observation group and 73.33% in the control group. By χ^2 test, the difference between the two groups was statistically signifcant （P 〈 0.05）. The postoperative residual stone rate （3.33%） and recurrence rate （6.67%） of the observation group were lower than those of the control group （20.00%） and recurrence rate （26.67%）. By χ^2 test, the difference between the two groups was statistically significant （P 〈 0.05）. There was no significant difference in ALT, AST and ALP between the two groups before treatment （P 〉 0.05）. After treatment, ALT, AST, ALP and other liver function indicators of the two groups were signifcantly lower than before treatment, the difference was statistically signifcant （P 〈 0.05）. After treatment, ALT, AST and ALP in the observation group were lower than those in the control group, and the difference was statistically signifcant （P 〈 0.05）. Conclusion For the patients with hepatolithiasis with bile duct stricture, hepatic lobectomy is better than non hepatic lobectomy, and it can also improve the liver function index, reduce the rate of residual stone and recurrence rate.

关 键 词：肝胆管结石 胆管狭窄 肝叶切除术 临床疗效 不同术式 对比 

分 类 号：R657[医药卫生—外科学]