双镜联合胆总管探查术后序贯液电碎石术在胆总管结石中的应用  

Application of sequential electrohydraulic lithotripsy in choledocholithiasis after bimirror combined with common bile duct exploration

作　　者：纪来伟 孙铎[1] 宋铎[1] 姜德帅 JI Lai-wei;SUN Duo;SONG Duo;JIANG De-shuai(The First Department of Hepatobiliary Surgery,Shenyang Fourth People's Hospital,Liaoning Province,Shenyang 110035,China)

机构地区：[1]沈阳市第四人民医院肝胆一外科,辽宁沈阳110035

出　　处：《中国当代医药》2021年第4期92-94,98,共4页China Modern Medicine

摘　　要：目的探讨双镜联合胆总管探查术后序贯液电碎石术对胆总管结石患者一次性结石取净率及恢复的影响。方法选取2019年2月~2020年2月沈阳市第四人民医院收治的67例胆总管结石患者作为研究对象,按照随机数字表法分为对照组(33例)与观察组(34例)。对照组采用双镜联合胆总管探查方法,观察组采用双镜联合胆总管探查术后序贯液电碎石术方法。比较两组的一次性结石取净率、白细胞计数(WBC)、总胆红素(TBil)、谷氨酰转肽酶(GGT)水平情况及并发症发生情况。结果两组手术均顺利完成且结石取净率为100%;观察组的术中出血量少于对照组,手术、胆管出血、排气及住院时间均短于对照组,差异有统计学意义(P<0.05);术后观察组的WBC、TBil、GGT水平低于对照组,差异有统计学意义(P<0.05);观察组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论双镜联合胆总管探查术后序贯液电碎石术对胆总管结石患者治疗效果显著,可彻底清除结石,降低WBC、TBil水平,且无并发症增加,促进术后恢复,值得借鉴。Objective To explore the effect of sequential electrohydraulic lithotripsy after bimirror combined with common bile duct exploration on the one-time caculus removal rate and recovery of patients with choledocholithiasis.Methods A total of 67 patients with choledocholithiasis treated in Shenyang Fourth People's Hospital,Liaoning Province from February 2019 to February 2020 were selected as the research objects.According to the random number table method,they were divided into control group(33 cases)and an observation group(34 cases).The control group adopted bimirror combined with common bile duct exploration method,the observation group adopted sequential electrohydraulic lithotripsy after bimirror combined common bile duct exploration.The one-time caculus removal rate,white blood cell count(WBC),total bilirubin(TBil),glutamyl transpeptidase(GGT)levels improvement and complications were compared between the two groups.Results The operations in the two groups were successfully completed and the caculus removal rate was 100%;the intraoperative blood loss of the observation group was less than that of the control group,and the time of operation,biliary bleeding,exhaust and hospitalization time were shorter than those of the control group,the differences were statistically significant(P<0.05);the WBC,TBil,and GGT levels of the observation group after surgery were lower than those of the control group,the differences were statistically significant(P<0.05);the total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Sequential electrohydraulic lithotripsy after bimirror combined with common bile duct exploration for patients with choledocholithiasis has a significant effect,which can completely remove the calculus and decrease WBC,TBil levels,and there is no obvious increase in complications,and is worth learning from.

关 键 词：胆总管结石 双镜 序贯液电碎石术 结石取净率 恢复 

分 类 号：R657.42[医药卫生—外科学]