腹腔镜与胆道镜治疗胆囊结石合并胆总管结石的疗效评价  

Efficacy evaluation of laparoscopy and choledochoscope in the treatment of cholecystolithiasis with choledocholithiasis

作　　者：顾勇劲[1] GU Yong-jin(Changshu Second People’s Hospital,Changshu 215500,China)

机构地区：[1]江苏省常熟市第二人民医院,215500

出　　处：《中国实用医药》2021年第20期45-48,共4页China Practical Medicine

摘　　要：目的探讨腹腔镜与胆道镜治疗胆囊结石合并胆总管结石的临床疗效。方法300例胆囊结石合并胆总管结石患者,将2014年2月~2017年2月收治的150例患者作为对照组,将2017年3月~2020年3月收治的150例患者作为观察组。对照组采取传统开腹手术治疗,观察组实施腹腔镜+胆道镜手术治疗。对比两组患者的临床疗效、治疗前后炎症指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)、白细胞介素-6(IL-6)]和并发症发生情况。结果观察组治疗总有效率为96.67%,高于对照组的84.00%,差异有统计学意义(P<0.05)。治疗后,观察组患者的CRP、TNF-α、WBC、IL-6水平均低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率为4.00%,低于对照组的22.67%,差异有统计学意义(P<0.05)。结论对胆囊结石合并胆总管结石患者应用腹腔镜+胆道镜治疗可提升其手术治疗有效率,改善炎症反应,且治疗安全性较高。Objective To discuss the clinical efficacy of laparoscopy and choledochoscope in the treatment of cholecystolithiasis with choledocholithiasis.Methods Among 300 patients with cholecystolithiasis and choledocholithiasis,150 patients received from February 2014 to February 2017 were selected as the control group,and 150 patients received from March 2017 to March 2020 were selected as the observation group.The control group was treated with traditional open surgery,and the observation group was treated with laparoscopy and choledochoscope.The clinical efficacy,inflammation indicators[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),white blood cell count(WBC),interleukin-6(IL-6)]before and after treatment and occurrence of complications were compared between the two groups.Results The total effective rate of treatment of the observation group was 96.67%,which was higher than 84.00%of the control group,and the difference was statistically significant(P<0.05).After treatment,the CRP,TNF-α,WBC and IL-6 of the observation group was lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of complications of the observation group was 4.00%,which was lower than 22.67%of the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopy and choledochoscopy can improve the efficiency of surgical treatment,improve the inflammatory reaction of patients with cholecystolithiasis and choledocholithiasis,and the treatment safety is high.

关 键 词：腹腔镜 胆道镜 胆囊结石 胆总管结石 临床疗效 

分 类 号：R657.4[医药卫生—外科学]