双镜联合与开腹手术治疗急性梗阻性化脓性胆管炎效果及对TBil、ALP、ALT水平的影响  

Effect of Double-mirror Combintion and Open Surgery on Acute Obstructive Suppurative Cholangitis and Its Influence on TBil,ALP and ALT

作　　者：黄宁[1] HUANG Ning(Beijing Changping District Hospital,Beijing 102200,China)

机构地区：[1]北京市昌平区医院,北京102200

出　　处：《中国医学创新》2020年第8期48-51,共4页Medical Innovation of China

摘　　要：目的:观察比较双镜联合与开腹手术治疗急性梗阻性化脓性胆管炎(AOSC)的效果及对TBil、ALP、ALT水平的影响。方法:选择2015年1月-2018年12月本院收治的80例诊断为AOSC的患者作为研究对象,按照随机数字表法分为传统组(n=40)与双镜组(n=40)。其中传统组采取开腹手术治疗,而双镜组则采取双镜联合(即胆道镜和腹腔镜)下胆总管切开取石术治疗,对患者进行8个月的随访。对比两组治疗前后肝功能水平和治疗后的临床效果、术后相关并发症发生率及复发率。结果:两组治疗后肝功能水平均明显降低,且双镜组肝功能水平均明显低于传统组(P<0.05);双镜组临床治疗总有效率为97.5%,明显高于传统组的85.0%(P<0.05);双镜组并发症发生率为2.5%,复发率为0,均明显低于传统组的17.5%、10.0%,差异均有统计学意义(P<0.05)。结论:在AOSC的相关治疗中,采取双镜联合手术治疗,可明显改善术后肝功能水平,减少术后并发症,有效提高治疗效果,减少术后复发,效果理想。Objective:To observe and compare the effect of double-mirror combintion and open surgery on acute obstructive suppurative cholangitis(AOSC)and its influence on TBil,ALP and ALT.Method:A total of 80 patients with AOSC treated in our hospital from January 2015 to December 2018 were selected as the objects.They were randomly divided into the traditional group(n=40)and the double-mirror group(n=40).The traditional group was treated by open surgery,while the double-mirror group was treated by double-mirror combintion choledocholithotomy(choledochoscopy combined with laparoscopy),and the patients were followed up for 8 months.The levels of hepatic function factors before and after treatment,clinical efficacy,postoperative complications and recurrence rate of two groups were compared.Result:After treatment,the levels of hepatic function factors in two groups were significantly decreased,the levels of TBil,ALP and ALT in the double-mirror group were significantly lower than those in the traditional group(P<0.05).The total effective rate of clinical treatment in the double-mirror group was 97.5%,which was significantly higher than 85.0%in the traditional group(P<0.05).The incidence of complications was 2.5%and the recurrence rate was 0 in the double-mirror group,they were significantly lower than 17.5%and 10.0%in the traditional group(P<0.05).Conclusion:In the treatment of AOSC,the double-mirror combination and surgery therapy can significantly improve the level of TBil,ALP and ALT,reduce the incidence of complications,effectively improve the therapeutic effect,reduce the recurrence after operation,and the effect is ideal.

关 键 词：双镜联合 开腹手术 急性梗阻性化脓性胆管炎 TBIL ALP ALT 

分 类 号：R657.4[医药卫生—外科学]