ERCP+LC术对比开放式手术治疗胆总管结石患者的临床效果分析  

Comparison on the clinical effect of ERCP+LC operation and open operation in the treatment of patients with choledocholithiasis

作　　者：廖方[1] 廖锦岐[1] 邱金伦 段进东[1] Liao Fang;Liao Jinqi;Qiu Jinlun;Duan Jindong(Department of hepatobiliary,Huizhou first people's hospital,Huizhou,Guangdong,516001,China)

机构地区：[1]惠州市第一人民医院肝胆科,广东惠州516001

出　　处：《齐齐哈尔医学院学报》2021年第18期1586-1589,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨分析ERCP(经内镜逆行性胰胆管造影术)+LC(腹腔镜胆囊切除)术对比开放式手术治疗胆总管结石患者的临床效果。方法选择2016年1月—2020年10月在本院确诊并接受治疗的胆总管结石患者70例作为研究对象,采用随机抽签分组,其中接受LC术结合胆总管切开术治疗31例患者为对照组;接受ERCP结合LC术治疗的39例患者为研究组。对两组患者最后治疗结局进行对比和分析。结果研究组患者手术时间,相较于对照组患者明显较长,同时研究组患者的术中失血量、术后活动时间以及住院时间相较于对照组患者明显较短(P<0.05);研究组患者术后的肝功能指标、以及生化指标水平,相较于对照组患者而言明显较优(P<0.05);两组患者手术前肝功能指标以及生化指标水平,相对比不存在明显差异性(P>0.05);研究组患者的术后排气时间、排便时间以及肠鸣音恢复时间,相对比于对照组患者而言明显较短(P<0.05);研究组患者的术后并发症发生率为5.13%,明显低于对照组的22.58%(P<0.05)。结论胆总管结石患者以ERCP结合LC术为治疗方案,与以往开放式手术治疗对比,患者术后肝功能、以及各项生化指标水平恢复明显,术后胃肠功能恢复速度加快,同时术后出现并发症的几率降低,对于促进患者术后快速恢复的价值明显。Objective To explore and analyze the clinical effect of ERCP(endoscopic retrograde cholangiopancreatography)+LC(laparoscopic cholecystectomy)and open surgery in the treatment of patients with choledocholithiasis.Methods In this study,70 patients with common bile duct stones who were diagnosed and treated in our hospital were selected as study subjects.The study period was from January 2016 to October 2020.The 31 cases of patients received LC combined with choledochendysis were enrolled in the control group,and the 39 patients who received ERCP combined with LC were enrolled in the study group.The final treatment outcome of the two groups was compared and analyzed.Results The operation time of the study group was significantly longer than that of the control group.However,the blood loss,postoperative activity time,and hospital stay of the study group were significantly shorter than those of the control group(P<0.05).The liver function indexes and biochemical index levels of patients in the study group were significantly better than those in the control group(P<0.05);There were no significant difference in the liver function indexes and biochemical index levels between the two groups of patients before surgery(P>0.05);The postoperative exhaust time,defecation time and bowel sound recovery time of the patients in the study group were significantly shorter than those in the control group(P<0.05);The incidence of postoperative complications was 5.13%in the study group,which was significantly lower than 22.58%of the control group(P<0.05).Conclusions Compared with the previous open surgical treatment,the treatment plan of ERCP combined with LCfor patients with choledocholithiasis,makes the liver function and the level of various biochemical indicators recovery significantly after surgery,and the recovery of gastrointestinal function after surgery has been accelerated.The probability of complications is reduced,which is of obvious value in promoting rapid recovery of patients after surgery.

关 键 词：胆总管结石 经内镜逆行性胰胆管造影术 腹腔镜胆囊切除术 胆总管切开术 生化指标 

分 类 号：R657.4[医药卫生—外科学]