精准肝切除术与非规则性肝切除术治疗肝内胆管结石疗效的对比研究  

Comparative Study of the Curative Effect of Precision Hepatectomy and Irregular Hepatectomy in the Treatment of Intrahepatic Bile Duct Stones

作　　者：杨小兵 YANG Xiao-bing(Department of General Surgery,Huaian Hospital,Huaian,Jiangsu Province,223200 China)

机构地区：[1]淮安市淮安医院普外科,江苏淮安223200

出　　处：《中外医疗》2020年第35期24-26,共3页China & Foreign Medical Treatment

摘　　要：目的比较精准肝切除术与非规则性肝切除术治疗肝内胆管结石的疗效。方法方便选取2014年12月—2019年12月该院收治的72例肝内胆管结石患者作为研究对象,按照手术方式的不同将患者分成观察组和对照组各36例。对照组采取非规则性肝切除手术治疗,观察组采取精准肝切除术治疗,比较手术疗效、临床症状缓解时间、手术相关指标、并发症以及治疗后的相关肝功能指标。结果观察组手术成功率和结石清除率高于对照组;观察组的相关临床症状缓解时间短于对照组,观察组的肛门排气时间、禁食时间、首次下床时间以及住院时间均短于对照组,差异有统计学意义(P<0.05);观察组的并发症发生率为5.56%低于对照组的22.22%,差异有统计学意义(χ^2=4.181,P=0.041);观察组的相关肝功能指标如ALT、TBIL、ALP、TBA以及GGT均优于对照组,差异有统计学意义(t=5.009、8.833、6.022、12.309、9.418,P<0.05)。结论采用精准肝切除术治疗肝内胆管结石,不仅可以提高结石清除率,降低并发症发生,还可降低手术对肝功能损害,有利于患者更好恢复,值得临床推广。Objective To compare the curative effect of precision hepatectomy and irregular hepatectomy in the treatment of intrahepatic bile duct stones.Methods A total of 72 patients with intrahepatic bile duct stones admitted to the hospital from December 2014 to December 2019 were conveniently selected as the research objects,and the patients were divided into observation group and control group with 36 cases each according to different surgical methods.The control group was treated with irregular hepatectomy,and the observation group was treated with precision hepatectomy.The efficacy of the operation,clinical symptom relief time,operation-related indicators,complications,and related liver function indicators after treatment were compared.Results The surgical success rate and stone removal rate of the observation group were higher than those of the control group;the relief time of related clinical symptoms in the observation group was shorter than that of the control group,and the time of anal exhaustion,fasting time,first getting out of bed and hospital stay in the observation group were shorter than the control group,the difference was statistically significant(P<0.05);the complication rate of the observation group was 5.56%lower than that of the control group 22.22%,the difference was statistically significant(χ^2=4.181,P=0.041);the relevant liver function indexes of the observation group such as ALT,TBIL,ALP,TBA and GGT were better than the control group,the difference was statistically significant(t=5.009,8.833,6.022,12.309,9.418,P<0.05).Conclusion The use of precision hepatectomy for the treatment of intrahepatic bile duct stones can not only improve the stone removal rate and reduce the occurrence of complications,but also reduce the damage to liver function caused by the operation,which is beneficial to the better recovery of patients and is worthy of clinical promotion.

关 键 词：精准肝切除 非规则性肝切除 胆管结石 手术疗效 结石清除率 

分 类 号：R657[医药卫生—外科学]