术中B超联合胆道镜、CT阅片对照定位精准治疗复杂性肝胆管结石临床研究  

Clinical Study of Intraoperative B-mode Ultrasound Combined with Choledochoscope and CT Scanning for Accurate Location and Treatment of Complex Hepatolithiasis

作　　者：何龙光[1] 黄丽娜 车斯尧[1] 陈钦寿[1] HE Longguang;HUANG Lina;CHE Siyao;CHEN Qinshou(Department of Hepatobiliary Surgery,Gaozhou People’s Hospital,Gaozhou 525200,China;不详)

机构地区：[1]高州市人民医院,广东高州525200

出　　处：《现代医院》2020年第10期1551-1553,共3页Modern Hospitals

基　　金：茂名市科技立项(2019162)。

摘　　要：目的探讨术中B超联合胆道镜、CT阅片对照定位精准治疗复杂性肝胆管结石的临床疗效。方法选取2018年1月—2019年9月就诊于我院的复杂性肝胆管结石患者110例作为研究对象,按照随机数字表法分为单一组和联合组,单一组采用常规传统胆道探查取石术联合组采用术中B超联合纤维胆道镜、术中CT阅片对照定位,对比两组患者疗效、术中出血量、术后胆漏、胆道出血等并发症、结石残留率,评价不同治疗效果。结果联合组总体疗效高于单一组(94.55%vs 78.18%,P <0.05);联合组术中出血量低于单一组(150±25.5 ml vs 280±32ml,P<0.05)、两组患者术后胆漏发生率联合组低于单一组(4.27%vs 9.09%,P<0.05)、术后胆道出血率联合组低于单一组(3.64%vs 9.09%,P<0.05)、联合组结石残留率低于单一组(5.64%vs 15.45%,P<0.05)。结论对复杂性肝胆管结石患者给予B超联合纤维胆道镜及术中CT阅片对照定位可显著提高疗效,便于精准定位结石位置,减少术中出血量,降低结石残留率和术后胆漏、胆道出血发生率,可予以临床推广应用。Objective To investigate the clinical effect of intraoperative B-mode ultrasonography combined with choledochoscope and CT in the treatment of complex hepatolithiasis. Methods 110 patients with complex hepatolithiasis who were treated in our hospital from January 2018 to September 2019 were selected as the study subjects. They were divided into two groups: the single group and the combined group according to the random number table method. The single group was treated by conventional exploration and lithotripsy. The combined group was positioned by intraoperative B-mode ultrasonography combined with fiberoptic choledochoscopy and intraoperative CT examination. The curative effect,intraoperative bleeding volume,postoperative biliary leakage,biliary tract hemorrhage and other complications,residual rate of stones were compared between the two groups,and different therapeutic effects were evaluated. Results The overall curative effect of the combined group was higher than that of the single group( 94. 55% vs 78. 18%,P < 0. 05);the intraoperative bleeding volume of the combined group was lower than that of the single group( 150 + 25. 5 ml vs 280 + 32 ml,P < 0. 05);the incidence of postoperative biliary leakage in the combined group was lower than that of the single group( 4. 27% vs 9. 09%,P <0. 05);and the incidence of postoperative biliary bleeding in the combined group was lower than that in the single group( 3. 64%). The residual rate of stones in combined group was lower than that in single group( 5. 64% vs 15. 45%,P <0. 05). Conclusion B-mode ultrasound combined with fiberoptic choledochoscope and intraoperative CT examination can significantly improve the curative effect of patients with complex hepatolithiasis. It is convenient to precisely locate the location of calculi,reduce the amount of bleeding during operation,reduce the residual rate of calculi and the incidence of bile leakage and biliary tract hemorrhage after operation. It is thus worthy of clinical promotion.

关 键 词：B超 胆道镜 术中CT阅片 复杂性肝胆管结石 

分 类 号：R656[医药卫生—外科学]