肝内胆管结石采用胆肠吻合术与部分肝切除术对患者结石残留率及复发率的影响和安全性分析  

Analysis of Safety and Effect on Choledochojejunostomy and Partial Hepatectomy on the Residual Rate and Recurrence Rate of Intrahepatic Bile Duct Calculi

作　　者：王刚 WANG Gang(Department of General Surgery,Lankao No.1 Hospital,Kaifeng Henan 475300,China)

机构地区：[1]兰考第一医院普外科,河南开封475300

出　　处：《临床研究》2020年第5期43-44,共2页Clinical Research

摘　　要：目的探讨肝内胆管结石采用胆肠吻合术与部分肝切除术对患者结石残留率及复发率的影响和安全性。方法选取兰考第一医院自2015年2月-2018年2月收治的62例肝内胆管结石患者为研究对象,根据患者的入院顺序交替的分为实验组(31例)和对照组(31例),其中对照组给予胆肠吻合术治疗,实验组给予部分肝切除术治疗,比较两组患者的结石残留率、复发率及术后并发症发生率。结果实验组患者的术中出血量、手术时间及住院时间均低于对照组相应时间(P<0.05)。实验组患者的临床疗效优良率为93.55%,高于对照组的71.00%(P<0.05);实验组患者的结石残留率为9.68%,低于对照组的32.26%(P<0.05);结石复发率组间比较差异无统计学意义(P>0.05);两组术后并发症比较无显著差异(P>0.05)。结论部分肝切除术相对于胆肠吻合术治疗肝内胆管结石效果更佳,有着较低结石残留率及复发率,较高安全性,值得临床应用。Objective To investigate the effect and safety of choledochojejunostomy and partial hepatectomy on the residual rate and recurrence rate of intrahepatic bile duct calculi.Methods 62 cases of intrahepatic biliary calculi patients admitted to Lankao No.1 Hospital from February 2015 to February 2018 were selected as the research objects and were divided into experimental group(31 cases)and control group(31 cases)according to patients’hospitalized order alternate.The control group were given bravery intestinal anastomosis treatment,while the treatment group were given partial liver resection.The residual rate,recurrence rate and postoperative complication rate of the two groups were compared.Results The amount of intraoperative blood loss,operation time and hospital stay of the experimental group were lower than those of the control group(P<0.05).The rate of excellent clinical efficacy in the experimental group(93.55%)was higher than that in the control group(71.00%),(P<0.05).The residual rate of calculi in the experimental group was 9.68%,which was lower than thatin the control group(32.26%),(P<0.05).There was no statistically significant difference in the recurrence rate between groups(P>0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion Partial hepatectomy is more effective than biliary enterostomy in the treatment of intrahepatic bile duct calculi,which has lower residual rate and recurrence rate of calculi,higher safety and is worthy of clinical application.

关 键 词：肝内胆管结石 胆肠吻合术 部分肝切除术 安全性 

分 类 号：R657.42[医药卫生—外科学]