不同取石术对胆总管结石的临床疗效研究  

Clinical Effect of Different Lithotomy on Choledocholithiasis

作　　者：李福 王素平 张敏 Li Fu;Wang Suping;Zhang Min(Department of Gastroenterology,Dongda Hospital,Shan County,Heze City,Shandong Province,Heze 274300,China)

机构地区：[1]山东省菏泽市单县东大医院消化内科,山东菏泽274300

出　　处：《巴楚医学》2021年第4期60-64,共5页Bachu Medical Journal

基　　金：山东省医药卫生科技计划项目(No:KYA181)。

摘　　要：目的:探讨经内镜逆行胰胆管造影(ERCP)取石术与经皮经肝胆道穿刺置管(PTCD)取石术治疗胆总管结石的临床效果。方法:选取2017年1月-2018年3月于我院就诊的胆总管结石患者70例,根据患者入院时间单双号分为A组(35例,行ERCP手术)和B组(35例,行PTCD手术),观察两组患者一般临床指标、术后胆道功能、临床疗效、术后并发症和生活质量情况。结果:术前两组患者的胆道压力、胆红素水平无明显差异(均P<0.05)。术后两组患者的胆道压力、胆红素水平均较术前明显降低,且B组明显低于A组(均P<0.05)。术后12个月,B组临床治疗总有效率明显高于A组(97.14%vs 74.29%,P<0.05)。A组并发症的发生率、复发率均显著高于B组(P<0.05)。结论:PTCD可降低胆总管结石患者的胆道压力及胆红素水平,减少并发症及术后复发,并改善患者的生活质量。Objective:To investigate the clinical effect of lithotomy via endoscopic retrograde cholangiopancreatography(ERCP)or lithotomy via percutaneous transhepatic cholangial drainage(PTCD)on choledocholithiasis.Methods:A total of 70 patients with choledocholithiasis in our hospital from January 2017 to March 2018 were selected and divided into Group A(35 cases underwent ERCP operation)and Group B(35 cases underwent PTCD operation)according to the odd or even number of admission time.General clinical indicators,postoperative biliary tract function,clinical efficacy and postoperative complications were observed.Results:There were no significant differences in preoperative biliary pressure and bilirubin level between Group A and Group B(both P<0.05).The biliary pressure and bilirubin level in both groups were decreased after operation,and Group B was significantly lower than those in Group A(all P<0.05).Twelve months after operation,the total effective rate was higher in Group B,when compared with Group A(97.14%vs 74.29%,P<0.05).The incidence of complication and recurrence rate in Group A were significantly higher than those in Group B(both P>0.05).Conclusion:Lithotomy via PTCD could reduce biliary tract pressure and bilirubin level,decrease incidence of complication and recurrencerate,which improve the quality of life in patients with choledocholithiasis.

关 键 词：胆总管结石 内镜逆行胰胆管造影取石术 经皮经肝胆道穿刺置管取石术 

分 类 号：R575.5[医药卫生—消化系统]