三镜联合胆道支架胆总管一期缝合术对肝外胆总管结石患者肝功能及应激反应的影响  

Effects of three endoscopies combined with biliary stenting and primary closure of the common bile duct on liver function and stress response in patients with extrahepatic choledocholithiasis

作　　者：陈坤 杨磊 CHEN Kun;YANG Lei(Jingyang County Hospital,Xianyang 713700,China)

机构地区：[1]泾阳县医院,陕西咸阳713700

出　　处：《临床医学研究与实践》2021年第29期98-100,共3页Clinical Research and Practice

摘　　要：目的探讨三镜联合胆道支架胆总管一期缝合术对肝外胆总管结石患者肝功能及应激反应的影响。方法选取2018年2月至2020年2月收治的116例肝外胆总管结石患者为研究对象,以数字法随机分为对照组和观察组,各58例。对照组采用腹腔镜胆总管探查胆总管一期缝合术,观察组采用三镜联合胆道支架胆总管一期缝合术。比较两组的肝功能指标、应激反应指标、住院时间、胆漏发生率及结石清除率。结果术前及术后7 d,两组的谷草转氨酶(AST)、谷丙转氨酶(ALT)水平无显著差异(P>0.05);术后1 d,观察组的AST、ALT水平低于对照组(P<0.05)。术前及术后即刻,两组的肾上腺素(E)、皮质醇(Cor)、C反应蛋白(CRP)水平无显著差异(P>0.05)。观察组的住院时间短于对照组(P<0.05);两组的胆漏发生率、结石清除率无显著差异(P>0.05)。结论三镜联合胆道支架胆总管一期缝合术治疗肝外胆总管结石患者有助于加快肝功能恢复,缩短住院时间,且不会加重机体应激反应,并发症少,结石清除率高,值得推广。Objective To investigate the effects of three endoscopies combined with biliary stenting and primary closure of the common bile duct on liver function and stress response in patients with extrahepatic choledocholithiasis.Methods A total of 116 patients with extrahepatic choledocholithiasis treated from February 2018 to February 2020 were selected and randomly divided into control group and observation group by digital method,with 58 cases in each group.The control group was treated with laparoscopic common bile duct exploration and primary closure of the common bile duct,and the observation group was treated with three endoscopies combined with biliary stenting and primary closure of the common bile duct.The liver function indexes,stress response indexes,hospitalization time,incidence of bile leakage and stone clearance rate were compared between the two groups.Results There were no significant differences in the levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)between the two groups before and at 7 d after operation(P>0.05);at 1 d after operation,the levels of AST and ALT in the observation group were lower than those in the control group(P<0.05).There were no significant differences in the levels of epinephrine(E),cortisol(Cor)and C-reactive protein(CRP)between the two groups before and immediately after operation(P>0.05).The hospitalization time of the observation group was shorter than that of the control group(P<0.05);there were no significant differences in the incidence of bile leakage and stone clearance rate between the two groups(P>0.05).Conclusion Three endoscopies combined with biliary stenting and primary closure of the common bile duct in the treatment of patients with extrahepatic choledocholithiasis is helpful to accelerate the recovery of liver function,shorten the hospitalization time,and will not aggravate the body's stress response,has less complications and high stone clearance rate,which is worthy of promotion.

关 键 词：三镜联合胆道支架胆总管一期缝合术 肝外胆总管结石 肝功能 应激反应 

分 类 号：R657.4[医药卫生—外科学]