经皮经肝胆道镜技术（PTCS）治疗复杂肝胆管结石的临床价值  

Clinical value of percutaneous transhepatic choledochoscopy(PTCS) in the treatment of complicated calculus of intrahepatic duct

作　　者：叶荣强[1] 钟鼎文[1] 谢元 邓小红[1] YE Rongqiang;ZHONG Dingwen;XIE Yuan;DENG Xiaohong(Department of Hepatobiliary and Pancreatic Surgery,the People's Hospital of Ganzhou City in Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省赣州市人民医院肝胆胰外科

出　　处：《中国现代医生》2019年第29期40-42,45,共4页China Modern Doctor

基　　金：江西省卫生计生委科技计划(20187249);江西省重点研发计划项目(20161BBG70026)

摘　　要：目的探讨对复杂肝胆管结石患者使用经皮经肝胆道镜(PTCS)技术治疗的实际效果和应用价值。方法选取2017年1~12月我院复杂肝胆管结石患者50例,按照随机数字表法将其均分为两组,每组25例,对照组行常规手术治疗;观察组行经皮经肝胆道镜技术治疗。分析两组结石清除效果和术后并发症,并于术后1年对患者进行随访。结果观察组和对照组结石清除率分别为92.00%和68.00%,观察组明显高于对照组(P<0.05)。观察组和对照组术后并发症发生率分别为8.00%和40.00%,观察组明显低于对照组(P<0.05)。观察组无结石复发出现,对照组2例患者结石复发,组间比较差异无统计学意义(χ^2=2.083,P=0.149>0.05)。结论经皮经肝胆道镜能够进行微创取石,远期疗效可观,可以有效治疗无法进行手术的复杂肝胆管结石,在临床上具有重要应用价值。Objective To analyze the practical effect and application value of percutaneous transhepatic cholangioscopy(PTCS)in patients with complicated calculus of intrahepatic duct.Methods 50 patients with complicated calculus of intrahepatic duct from January to December 2017 were enrolled in this study.According to the random number table method,they were divided into two groups,with 25 cases in each group.The control group was received routine surgery.The observation group was underwent percutaneous transhepatic choledochoscopy.The stone removal effect and postoperative complications were analyzed,and the patients were followed up 1 year after surgery.Results The stone removal rate of the observation group and the control group was 92.00%and 68.00%,respectively.The stone removal rate of observation group was significantly higher than that in the control group(P<0.05).The incidence of postoperative complications in the observation group and the control group was 8.00%and 40.00%,respectively,and the incidence of postoperative complications in the observation group was significantly lower than that in the control group,P<0.05.There was no recurrence of stones in the observation group,and 2 patients in the control group had recurrence of stones.There was no significant difference between the two groups(χ^2=2.083,P=0.149>0.05).Conclusion Percutaneous transhepatic cholangioscopy can be used for minimally invasive stone removal.It has a long-term curative effect and can effectively treat complicated calculus of intrahepatic duct that cannot be operated.It has important clinical value.

关 键 词：经皮经肝胆道镜 复杂肝胆管结石 并发症 临床价值 

分 类 号：R657.4[医药卫生—外科学]