两种不同碎石方法在经皮经肝胆管穿刺碎石取石术的效果比较  

Comparison on effects of two different methods of percutaneous transhepatic bile duct puncture lithotomy

作　　者：李晓锋[1] 曾宪成[1] 马力[1] 郑权[1] 高鹏[1] Li Xiaofeng;Zeng Xiancheng;Ma Li;Zheng Quan;Gao Peng(Second Department of General Surgery,Guangdong Second Provincial General Hospital,Guangzhou 510317,China)

机构地区：[1]广东省第二人民医院普外二科,广州510317

出　　处：《国际医药卫生导报》2019年第15期2490-2492,共3页International Medicine and Health Guidance News

摘　　要：目的研究U100激光碎石与气压弹道碎石在经皮经肝胆管穿刺碎石取石术中的效果。方法随机选取2017年4月至2019年3月本院普外二科收治的121例肝内外胆管结石的患者,分成两组:试验组,75例,采用超声引导下经皮经肝胆管穿刺硬质胆道镜取石+U100激光碎石术;对照组,46例,采用超声引导下经皮经肝胆管穿刺硬质胆道镜取石+气压弹道碎石术。比较两组手术时间、术中出血、残石率、术后疼痛、术后第1天肝功能。结果 试验组平均手术时间明显短于对照组,差异有统计学意义(P<0.05);试验组术中胆道出血情况少于对照组,差异有统计学意义(P<0.05);试验组术后残石率少于对照组,差异有统计学意义(P<0.05);试验组术后疼痛程度较对照组为轻,差异有统计学意义(P<0.05);两组术后第1天ALP、GGT、ALT和AST差异有统计学意义(均P>0.05)。结论 U100激光碎石在经皮经肝胆管穿刺硬质胆道镜碎石取石术中具有取石效率更好、术后残石率发生更小、术后疼痛更小等优点,对肝脏损伤可能更小,值得临床推广应用。Objective To compare the effects of U100 laser lithotripsy and pneumatic ballistic lithotripsy in percutaneous transhepatic bile duct exploration. Methods A total of 121 patients with intra- and extra-hepatic bile duct stones admitted to the Second Department of General Surgery of our hospital from April, 2017 to March, 2019 were selected and divided into two groups: an experimental group (n=75), treated by ultrasoundguided percutaneous transhepatic bile duct puncture and rigid choledochoscopy for stone removal and by U100 laser lithotripsy;and a control group (n=46), treated by ultrasound-guided percutaneous transhepatic bile duct puncture and rigid choledochoscopy for stone removal and by pneumatic ballistic lithotripsy. The operation time, intraoperative bleeding, residual stone rate, postoperative pain, and liver function on day 1 after the operation were compared between the two groups. Results The average operation time, intraoperative hemobilia, postoperative residual stone rate, and postoperative pain degree were better in the experimental group than in the control group,with statistical differences (all P < 0.05). There were no statistical differences in the levels of ALP, GGT, ALT, and AST the first day after the operation between these two groups (all P > 0.05). Conclusion U100 laser lithotripsy has better stone removal efficiency, lower postoperative residual stone rate, and less postoperative pain and liver damage in percutaneous transhepatic bile duct puncture and rigid choledochoscopy, so it is worthy of clinical application.

关 键 词：U100 气压弹道 肝胆管结石 胆道镜 

分 类 号：R657.42[医药卫生—外科学]