腹腔镜肝切除联合胆道镜取石术在肝胆管结石治疗中的效果及患者血清ALT、AST水平分析  

Effectiveness of Laparoscopic Hepatectomy Combined with Choledocho⁃scopic Lithotomy in the Treatment of Hepatobiliary Stones and Analysis of Patients'Serum ALT and AST Levels

作　　者：陈煌祥 曾文龙[1] CHEN Huangxiang;ZENG Wenlong(Department of Hepatobiliary Surgery,Longyan Second Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩市第二医院肝胆外科,福建龙岩364000

出　　处：《中外医疗》2022年第33期83-86,91,共5页China & Foreign Medical Treatment

摘　　要：目的探究腹腔镜肝切除联合胆道镜取石术在肝胆管结石治疗中效果及患者血清谷丙转氨酶(ALT)、谷草转氨酶(AST)水平的影响。方法方便选取2020年1-2021年12月福建省龙岩市第二医院收治的78例肝胆管结石患者作为研究对象,将2020年1-12月接受传统开腹手术治疗的39例患者纳入对照组,将2021年1-12月接受腹腔镜肝切除联合胆道镜取石术治疗的39例患者纳入观察组。比较两组结石清除率、肝功能指标水平(血清ALT、AST)、并发症发生率。结果术后1个月,观察组结石清除率(97.44%)明显比对照组(79.49%)高,差异有统计学意义(χ^(2)=4.522,P<0.05);术后7 d,观察组血清ALT水平为(32.69±5.27)U/L,明显比对照组(38.08±8.75)U/L低,差异有统计学意义(t=3.295,P<0.05);血清AST水平为(31.14±6.42)U/L,明显比对照组(36.16±7.31)U/L低,差异有统计学意义(t=3.222,P=0.002);观察组并发症发生率(2.56%)显著低于对照组(20.51%),差异有统计学意义(χ^(2)=4.522,P=0.033)。结论腹腔镜肝切除联合胆道镜取石术可以提高肝胆管结石治疗效果,有效清除结石,改善患者肝功能水平,并发症较少发生,安全性有保障。Objective To investigate the effect of laparoscopic hepatectomy combined with choledochoscopic lithotripsy in the treatment of hepatobiliary stones and the effect of serum alanine transaminase(ALT)and glutamic oxalacetic transaminase(AST)levels in patients.Methods 78 patients with hepatolithiasis admitted to the Second Hospital of Longyan City,Fujian Province from January 2020 to December 2021 were conveniently selected as the study subjects,39 patients who received traditional laparotomy from January to December 2020 were included in the control group,and 39 patients who received laparoscopic hepatectomy combined with choledochoscopy from January to December 2021 were included in the observation group.The stone clearance rate,liver function index levels(serum ALT,AST),and complication rates were compared between the two groups.Results 1 month after operation,the stone removal rate in the observation group(97.44%)was significantly higher than that in the control group(79.49%),the difference was statistically significant(χ^(2)=4.522,P<0.05).7 d after operation,the serum ALT level in the observation group was(32.69±5.27)U/L,which was significantly lower than that in the control group(38.08±8.75)U/L,and the difference was statistically significant(t=3.295,P<0.05).The serum AST level was(31.14±6.42)U/L,significantly lower than(36.16±7.31)U/L in the control group,the difference was statistically significant(t=3.222,P=0.002).The complication rate in the observation group(2.56%)was significantly lower than that in the control group(20.51%),the difference was statistically significant(χ^(2)=4.522,P=0.033).Conclusion Laparoscopic hepatectomy combined with choledochoscopic lithotomy can improve the treatment effect of hepatobiliary stones,effectively remove stones,improve patients'liver function level,less complications occur,and safety is guaranteed.

关 键 词：腹腔镜 胆道镜 肝功能 肝胆管结石 取石术 肝切除术 

分 类 号：R575[医药卫生—消化系统]