经第一肝门入路与经肝圆韧带裂入路手术治疗左肝内胆管结石的效果对比  

Comparison on Effect of Surgical Treatment of Left Intrahepatic Duct Stone Through First Hilar and Hepatic Ligament Teres Fissure

作　　者：吕贞贞 LÜ Zhenzhen(Department of Hepatobiliary and Gastrointestinal Surgery,Shangqiu First People’s Hospital,Shangqiu 476100,China)

机构地区：[1]商丘市第一人民医院肝胆胃肠外科,河南商丘476100

出　　处：《河南医学研究》2021年第36期6792-6795,共4页Henan Medical Research

摘　　要：目的比较经第一肝门入路与经肝圆韧带裂入路手术治疗左肝内胆管结石的效果。方法选取2018年1月至2021年7月商丘市第一人民医院收治的110例左肝内胆管结石患者为研究对象,采用随机数表法分为对照组与观察组,各55例,对照组接受经第一肝门入路手术,观察组接受经肝圆韧带裂入路手术。统计并比较两组患者手术及恢复指标[手术时间、术中出血量、肛门排气时间、住院时间];检测并比较两组术前、术后1个月肝功能指标[总胆红素(T-Bil)、谷丙转氨酶(ALT)、血清白蛋白(ALB)、肝细胞生长因子(HGF)]。结果观察组手术时间长于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后1个月,两组T-Bil、ALT水平较术前下降,ALB、HGF水平较术前升高(P<0.05),且观察组HGF水平高于对照组,差异有统计学意义(P<0.05)。结论与经第一肝门入路相比,经肝圆韧带裂入路虽然手术时间较长,但能够减少术中出血量,促进肝功能的恢复。Objective To compare the effect of surgical treatment through first hilar and hepatic ligament teres fissure in the treatment of left intrahepatic duct stone.Methods A total of 110 patients with left intrahepatic duct stone treated in Shangqiu First People’s Hospital from January 2018 to July 2021 were selected as the research subjects,a random number table method was used to divide them into control group and observation group,with 55 cases in each group.Patients in the control group were operated through the first hilar,and the patients in the observation group were operated through the hepatic ligament teres fissure.The operation and recovery indexes[operation time,intraoperative bleeding,anal exhaust time and hospitalization time]of the two groups were counted and compared,and the indexes of liver function[total bilirubin(T-Bil),alanine aminotrasferase(ALT),serum albumin(ALB)and hepatocyte growth factor(HGF)]before and 1 month after operation were measured and compared between the two groups.Results Compared with the control group,the operation time was longer and the amount of intraoperative bleeding was less in the observation group(P<0.05).One month after operation,the levels of T-Bil and ALT were decreased,and the levels of ALB and HGF were increased when compared with before operation,and the HGF level in the observation group was higher than that in the control group(P<0.05).Conclusion Compared with the first hilar approach,the hepatic ligament teres fissure takes a longer time,but it can reduce the amount of intraoperative bleeding and promote the recovery of liver function.

关 键 词：左肝内胆管结石 第一肝门入路 肝圆韧带裂入路 肝功能 

分 类 号：R656[医药卫生—外科学]