ERCP术与腹腔镜手术治疗胆总管结石的疗效对比及对血清AST、ALT、ALP的影响  

Comparison of ERCP and Laparoscopy in the Treatment of Common Bile Duct Stones and Their Effects on Serum AST, ALT and ALP

作　　者：任亚平 鲁正[2] 蔡昶[1] 马达 徐辉 REN Ya-ping;LU Zheng;CAI Chang;MA Da;XU Hui(Suzhou State Hospital,General Surgery,Suzhou,Anhui,234000,China;First Affiliated Hospital ofBengbu Medical College,Hepatobiliary Surgery,Bengbu,Anhui,233000,China)

机构地区：[1]宿州市立医院普外科,安徽宿州234000 [2]蚌埠医学院第一附属医院肝胆外科,安徽蚌埠233000

出　　处：《现代生物医学进展》2019年第18期3577-3580,共4页Progress in Modern Biomedicine

基　　金：安徽卫生厅医学科研课题（2014S6027）

摘　　要：目的:探讨内镜逆行胰胆管造影术(ERCP)与腹腔镜手术治疗胆总管结石的疗效对比及对血清门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)的影响。方法:选择2017年4月到2018年4月我院接诊的胆总管结石患者50例作为研究对象,以随机数表法分为观察组(n=26)和对照组(n=24),对照组使用腹腔镜手术治疗,观察组采用ERCP取石术治疗。比较两组手术时间、术中出血量、术后下床时间、住院时间、血清AST、ALT、ALP水平变化情况、术后胃肠道恢复时间及术后不良反应发生情况。结果:观察组患者手术时间高于对照组,(P<0.05),术中出血量、术后下床时间及住院时间均显著低于对照组(P<0.05);手术前,两组患者血清AST、ALT、ALP水平无明显差异;治疗后,两组患者血清AST、ALT、ALP水平均明显上升(P<0.05),且观察组患者血清AST、ALT、ALP水平显著低于对照组(P<0.05);观察组患者肠鸣音恢复时间、排气时间、排便时间均明显低于对照组(P<0.05);治疗期间,观察组患者不良反应总发生率为7.69%,显著低于对照组的29.17%(P<0.05)。结论:在胆总管结石患者中应用ERCP取石术效果显著,对患者血清血清AST、ALT、ALP影响较小,值得推广与运用。Objective: To study Comparison of ERCP and laparoscopy in the treatment of common bile duct stones and their effects on serum Aspartate aminotransferase(AST), alanine aminotransferase(ALT), alkaline phosphatase(ALP). Methods: 50 cases of choledocholithiasis in our hospital from April 2017 to April 2018 were selected as the study subjects, the patients were divided into observation group(n=26) and control group(n=24) by random number table. The control group was treated by laparoscopic surgery,while the observation group was treated by ERCP lithotripsy. The operation time, intraoperative bleeding volume, time to get out of bed after operation, hospital stay, changes of serum AST, ALT and ALP levels, recovery time of gastrointestinal tract and occurrence of adverse reactions after operation were compared between the two groups. Results: The operation time of the observation group was higher than that of the control group(P < 0.05), the amount of bleeding during operation, the time of getting out of bed after operation and the time of hospitalization were significantly lower than that of the control group(P < 0.05);before operation, the levels of AST,ALT and ALP in the serum of the two groups had no significant difference;after treatment, the levels of AST, ALT and ALP in the serum of the two groups increased significantly(P < 0.05), and the levels of AST, ALT and ALP in the observation group were significantly higher. The recovery time of bowel sounds, exhaust time and defecation time in the observation group were significantly lower than those in the control group(P < 0.05);the total incidence of adverse reactions in the observation group was 7.69%, significantly lower than29.17% in the control group(P < 0.05). Conclusion: The application of ERCP in choledocholithiasis is effective, and has little effect on serum AST, ALT and ALP. It is worth popularizing and applying.

关 键 词：内镜逆行胰胆管造影术 腹腔镜 胆总管结石 门冬氨酸氨基转移酶 丙氨酸氨基转移酶 碱性磷酸酶 

分 类 号：R657.42[医药卫生—外科学]