手术与内镜取石治疗胆管结石的效果及术后复发相关因素分析  

Curative effect of surgery and endoscopic stone extraction on bile duct stones and recurrence related factors

作　　者：吕品[1] Lyu Pin(Department of General Surgery, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China)

机构地区：[1]山西医科大学第二医院普外科,太原030001

出　　处：《中国实用医刊》2019年第12期78-81,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨手术、内镜取石治疗胆管结石的效果及术后复发的相关因素。方法选取2014年3月至2018年3月山西医科大学第二医院收治的胆管结石患者146例为研究对象,采用随机数表法分为观察组和对照组,每组73例。观察组给予开腹手术治疗,对照组给予内镜取石术治疗,比较两组疗效,并分析术后复发的危险因素。结果观察组术中出血量、手术时间、术后住院时间、并发症发生率均低于对照组(P均<0.05)。单因素分析结果显示,胆管结石患者术后复发与年龄、性别、合并症无相关性(P>0.05),与内镜取石术治疗、结石分布、肝内胆管狭窄、结石残留因素有相关性(P<0.05)。多因素Logistic回归分析发现内镜取石术治疗、结石分布、肝内胆管狭窄、结石残留是影响胆管结石患者术后复发危险因素(OR=1.430,95%CI=1.077~1.901;OR=1.342,95%CI=1.036~1.738;OR=1.758,95%CI=1.105~2.797;OR=1.436,95%CI=1.052~1.961,P<0.05)。结论手术治疗胆管结石的疗效优于内镜取石治疗,且内镜取石术治疗方法、结石分布、肝内胆管狭窄、结石残留是影响患者术后复发的危险因素,临床上应针对以上因素,做好预防措施,以促进胆管结石患者更快恢复,降低术后复发率。Objective To investigate the curative effect and recurrence related factors of surgical and endoscopic stone extraction for bile duct stones. Methods A total of 146 patients with bile duct stones admitted to the Second Hospital of Shanxi Medical University from March 2014 to March 2018 were enrolled. They were divided into observation group and control group by random number table method, with 73 cases in each group. The observation group was given surgery treatment. The control group was given endoscopic stone extraction. The curative effects of the two groups were compared. The risk factors affecting postoperative recurrence were analyzed. Results The intraoperative blood loss, operation time, postoperative hospital stay and incidence of complication in the observation group were significantly lower than those in the control group (P all<0.05). The results of univariate analysis showed that the postoperative recurrence of patients with bile duct stones were not associated with age, gender and comorbidity (P>0.05), but correlated with endoscopic stone extraction, distribution of bile duct stone, intrahepatic bile duct stenosis and residual bile duct stones (P<0.05). Multivariate logistic regression analysis found endoscopic stone extraction, distribution of bile duct stones, intrahepatic bile duct stenosis and residual bile duct stones were risk factors affecting postoperative recurrence in patients with bile duct stones (OR=1.430, 95% CI=1.077 - 1.901;OR=1.342, 95%CI=1.036 - 1.738;OR=1.758, 95%CI=1.105 - 2.797;OR = 1.436, 95%CI=1.052 - 1.961, P<0.05). Conclusions The curative effect of surgical treatment on bile duct stones is better than that of endoscopic stone extraction. The endoscopic stone extraction, distribution of bile duct stones, intrahepatic bile duct stenosis and residual bile duct stones are risk factors affecting postoperative recurrence in patients with bile duct stones. The preventive measures can be implemented for the above factors clinically to promote the better recovery of patients with bi

关 键 词：手术 内镜取石 胆管结石 疗效 复发 

分 类 号：R657.42[医药卫生—外科学]