胆道镜联合液电碎石术治疗难治性肝内胆管结石的临床效果  

Clinical effect of choledochoscopy combined with electrohydraulic lithotripsy in the treatment of refractory intrahepatic bile duct stones

作　　者：高景雷 刘军 皇甫行勋 王连才[2] 田玉伟[2] GAO Jinglei;LIU Jun;HUANGFU Xingxun;WANG Liancai;TIAN Yuwei(No.1 General Surgery Department,People's Hospital of Zhecheng County,Shangqiu 476200;Hepatobiliary and Pancreatic Surgery Department,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]柘城县人民医院普外一科,河南商丘476200 [2]河南省人民医院肝胆胰腺外科,河南郑州450003

出　　处：《临床医学研究与实践》2022年第6期101-103,共3页Clinical Research and Practice

摘　　要：目的研究胆道镜联合液电碎石术治疗难治性肝内胆管结石的临床效果。方法回顾性分析78例难治性肝内胆管结石患者的临床资料,根据治疗方法不同将患者分为对照组与观察组,各39例。对照组给予腹腔镜下胆道镜钬激光碎石术治疗,观察组给予胆道镜联合液电碎石术治疗。比较两组的临床效果。结果观察组的一次性结石取净率高于对照组(P<0.05)。术后,两组的hs-CRP、IL-6水平均升高,但观察组低于对照组(P<0.05)。观察组的术中出血量少于对照组,手术耗时、术后排便时间、住院时间均短于对照组(P<0.05)。观察组的并发症总发生率、复发率均低于对照组(P<0.05)。结论胆道镜联合液电碎石术治疗难治性肝内胆管结石的临床效果显著,可减轻炎症反应,减少术中出血量,缩短住院时间,降低并发症发生率及复发率。Objective To study the clinical effect of choledochoscopy combined with electrohydraulic lithotripsy in the treatment of refractory intrahepatic bile duct stones.Methods The clinical data of 78 patients with refractory intrahepatic bile duct stones were analyzed retrospectively.The patients were divided into control group and observation group according to different treatment methods,with 39 cases in each group.The control group was treated with laparoscopic choledochoscopy holmium laser lithotripsy,and the observation group was treated with choledochoscopy combined with electrohydraulic lithotripsy.The clinical effects of the two groups were compared.Results The one-time stone removal rate in the observation group was higher than that in the control group(P<0.05).After operation,the levels of hs-CRP and IL-6 in the two groups increased,but those in the observation group were lower than the control group(P<0.05).The amount of intraoperative bleeding in the observation group was less than that in the control group,and the operation time,postoperative defecation time and hospital stay in the observation group were shorter than those in the control group(P <0.05).The total incidence of complications and recurrence rate in the observation group were lower than those in the control group(P<0.05).Conclusion Choledochoscopy combined with electrohydraulic lithotripsy in the treatment of refractory intrahepatic bile duct stones has a significant clinical effect,it can reduce inflammatory reaction and the amount of intraoperative bleeding,shorten hospital stay,and reduce the incidence of complications and recurrence rate.

关 键 词：难治性肝内胆管结石 胆道镜 液电碎石 

分 类 号：R657.4[医药卫生—外科学]