经皮肝穿刺胆道镜取石术治疗肝内外胆管结石的效果  

Effect of percutaneous transhepatic choledochoscopy in the treatment of intrahepatic and extrahepatic cholelithiasis

作　　者：李康德[1] 王振龙[1] 陈博艺[1] 李称才[1] 罗晓峰[1] 余勇[1] 梁慧明 LI Kang-de;WANG Zhen-long;CHEN Bo-yi;LI Cheng-cai;LUO Xiao-feng;YU Yong;LIANG Hui-ming(Department of Hepatobiliary Surgery,Zhanjiang Central People′s Hospital of Guangdong Province,Zhanjiang 524000,China;Department of Clinical Laboratory,Zhanjiang Central People′s Hospital of Guangdong Province,Zhanjiang 524000,China)

机构地区：[1]广东省湛江中心人民医院肝胆外科,广东湛江524000 [2]广东省湛江中心人民医院检验科,广东湛江524000

出　　处：《中国当代医药》2019年第36期123-125,129,共4页China Modern Medicine

摘　　要：目的探讨经皮肝穿刺胆道镜取石术治疗肝内外胆管结石的效果。方法选取2017年5月~2018年5月我院肝胆外科收治的84例肝内外胆管结石患者作为研究对象,按照随机数字表法分为对照组(42例)和观察组(42例)。对照组采用传统胆总管切开取石+T管引流术,观察组采用经皮肝穿刺胆道镜取石。比较两组的临床治疗效果、围术期情况、术后恢复情况、并发症发生情况;比较两组治疗前后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及总胆红素(TBil)水平。结果观察组的治疗总有效率高于对照组,手术时间、胃肠功能恢复时间及住院时间短于对照组,术中出血量少于对照组,切口长度短于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者的ALT、AST、TBil水平比较,差异无统计学意义(P>0.05);治疗后,两组患者的ALT、AST、TBil水平低于治疗前,观察组的ALT、AST、TBil水平低于对照组,差异均有统计学意义(P<0.05)。观察组的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论对肝内外胆管结石患者采用经皮肝穿刺胆道镜取石术治疗,可提高临床治疗效果、缩短手术时间、胃肠功能恢复时间及住院时间,改善肝功能各项指标水平,降低术后并发症发生率,值得临床推广应用。Objective To explore the effect of percutaneous transhepatic choledochoscopy in the treatment of intrahepatic and extrahepatic cholelithiasis.Methods A total of 84 patients with intrahepatic and extrahepatic cholelithiasis admitted to hepatobiliary surgery of our hospital from May 2017 to May 2018 were selected as the study objects,they were divided into control group(42 cases)and observation group(42 cases)according to the random number table method.The control group was treated with traditional choledochotomy and T tube drainage,the observation group was treated with percutaneous transhepatic choledochoscopy.The clinical effect,perioperative situation,postoperative recovery and complications of the two groups were compared.The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)before and after treatment were compared.Results The total effective rate of the observation group was higher than that of the control group,the operation time,gastrointestinal function recovery time and hospitalization time were shorter than those of the control group,the amount of intraoperative bleeding was less than that of the control group,and the incision length was shorter than that of the control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in ALT,AST and TBil between the two groups(P>0.05).After treatment,the levels of ALT,AST and TBil in the two groups were lower than those before treatment,the levels of ALT,AST and TBil in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Percutaneous transhepatic choledochoscopy for the treatment of intrahepatic and extrahepatic cholelithiasis can improve the clinical treatment effect,shorten the operation time,gastrointestinal functi

关 键 词：经皮肝穿刺胆道镜取石术 传统胆总管切开取石 T管引流术 肝内外胆管结石 肝功能 

分 类 号：R364.25[医药卫生—病理学]