PTCS联合钬激光碎石在复杂性肝内外胆管结石中的疗效  

Therapeutic effect of PTCS combined with holmium laser lithotripsy for complicated intrahepatic and extrahepatic bile duct stones

作　　者：张旭峰 梁嘉毅 曹振 郭世称 何晓[2] 谢斌辉[2] 刘清泉[2] ZHANG Xufeng;LIANG Jiayi;CAO Zhen;无(GanNan medical university,Ganzhou,Jiangxi 341000;The first affiliated hospital of Gannan medical university,Hepatobiliary surgery,Ganzhou,Jiangxi 341000)

机构地区：[1]江西省赣南医学院,赣州341000 [2]江西省赣南医学院第一附属医院肝胆外科,赣州341000

出　　处：《江西医药》2021年第7期889-891,895,共4页Jiangxi Medical Journal

基　　金：国家自然科学基金项目,编号82060505;江西省自然科学基金青年项目,编号20192BAB215030。

摘　　要：目的探讨经皮肝胆管镜(Percutaneous transhepatic cholangioscopy,PTCS)联合钬激光碎石术在治疗复杂性肝内外胆管结石中的临床治疗效果。方法采用回顾性研究方法收集自2019年10月至2020年10月在赣南医学院第一附属医院就诊的复杂肝胆管结石病人的临床资料及随访资料。经过严格的筛选后,最终有72例病人纳入研究。根据所采用的手术方式不同,分为观察组和对照组,观察组36例患者采用PTCS联合钬激光碎石取石术治疗,对照组36例患者采用传统的开腹手术治疗,比较两组临床研究的疗效、相关临床治疗效果指标以及术后总并发症的发生率。结果观察组的治疗总有效率为97.22%显著高于对照组80.55%,差异具有统计学意义(P<0.05)。观察组的手术时间131.3±12.1min、住院时间10.8±2.4d、结石残留率(n%)(0.00%)明显短于对照组185.1±10.9min、16.3±4.2d、(13.88%),差异有统计学意义(P<0.05)。观察组的手术总并发症发生率为5.55%显著低于对照组33.33%,差异有统计学意义(P<0.05)。结论PTCS联合钬激光碎石取石术在治疗复杂性肝内外胆管结石的临床治疗效果显著,能够有效地清除结石,具有手术创伤小、术口整齐美观、术后恢复快、并发症发生率低等优势,值得在临床推广应用。Objective To explore the clinical efficacy of Percutaneous transhepatic cholangioscopy(PTCS)combined with holmium laser lithotripsy for the treatment of complicated intrahepatic and extrahepatic bile duct stones.Methods The study using retrospective research method collected the clinical data and follow-up data of patients with complex hepatolithiasis in the First Affiliated Hospital of Gannan Medical College from October 2019 to October 2020.After strict screening,72 patients were included in the study.According to the different operation methods,they were divided into the observation group and the control group.36 patients in the observation group were treated with PTCS combined with holmium laser lithotripsy,and 36 patients in the control group were treated with traditional open surgery.The efficacy,related indicators and the incidence of postoperative complications of the two groups were compared.Resuls The total effective rate of the observation group was 97.22%,which is significantly higher than 80.55%of the control group,the difference was statistically significant(P<0.05).The operation time(131.3±12.1),hospitalization time(10.8±2.4)and residual stone rate(n%)(0.00%)of the observation group were significantly shorter than those of the control group(185.1±10.9),(16.3±4.2),(13.88%),the difference was statistically significant(P<0.05).Conclusion PTCS combined with holmium laser lithotripsy in the treatment of complex intrahepatic and extrahepatic bile duct stones has significant clinical effect,which can effectively remove the stones.The operation has the advantages of small trauma,neat and beautiful mouth,fast postoperative recovery and low incidence of complications,which is worthy of clinical application.

关 键 词：经皮肝胆管镜 肝内胆管结石 钬激光碎石 临床价值 

分 类 号：R657.42[医药卫生—外科学]