经皮肝穿胆管球囊推石术治疗胆总管结石伴急性胆管炎的临床应用价值  

Clinical Application Value of Percutaneous Choledocholithiasis with Cholangitis Associated with Acute Cholangitis

作　　者：邱国时 黄火成 谢思新 陈广幸[4] QIU Guoshi;HUANG Huocheng;XIE Sixin;CHEN Guangxing(Department of Interventional Intervention,the Second People´s Hospital of Zhaoqing,Zhaoqing,Guangdong Province,526060 China;Department of General Surgery,the Second People´s Hospital of Zhaoqing,Zhaoqing,Guangdong Province,526060 China;Department of Intervention,Gaoyao District People´s Hospital of Zhaoqing,Zhaoqing,Guangdong Province,526040 China;Department of Oncology,the Second People´s Hospital of Zhaoqing,Zhaoqing,Guangdong Province,526040 China)

机构地区：[1]肇庆市第二人民医院介入科,广东肇庆526060 [2]肇庆市第二人民医院普外科,广东肇庆526060 [3]肇庆市高要区人民医院介入科,广东肇庆526040 [4]肇庆市第二人民医院肿瘤科,广东肇庆526040

出　　处：《中外医疗》2022年第35期120-123,共4页China & Foreign Medical Treatment

基　　金：肇庆市科技局(2021040314067)。

摘　　要：目的分析经皮肝穿胆管球囊推石术治疗胆总管结石伴急性胆管炎的临床应用价值。方法回顾性分析肇庆市第二人民医院2016年4月—2021年10月期间收治的60例胆总管结石伴急性胆管炎患者的临床资料,按治疗方式分为两组,每组30例。观察组接受经皮肝穿胆管球囊推石术治疗,对照组接受经皮肝胆道镜取石术治疗,比较两组患者术后总并发症发生率、结石清除率及围术期各项指标变化。结果观察组并发症总发生率(3.33%)低于对照组总发生率(30.00%),差异有统计学意义(χ^(2)=7.680,P<0.05);观察组手术时间(96.78±18.33)min、胆道引流管拔除时间(8.15±1.28)d、肛门排气时间(21.16±3.14)h均短于对照组,差异有统计学意义(t=15.295、56.615、10.049,P<0.05),但两组患者腹腔引流管拔除时间及住院时间比较,差异无统计学意义(P>0.05);观察组结石清除率为90.00%(27/30),高于对照组的60.00%(18/30),差异有统计学意义(P<0.05)。结论临床治疗胆总管结石伴急性胆管炎可采用经皮肝穿胆管球囊推石术治疗,能有效促进患者围术期恢复,且并发症发生率低,结石清除率高。Objective To analyze the clinical application value of percutaneous choledocholithiasis in the treatment of cholangitis associated with acute cholangitis.Methods Retrospective analysis of clinical data of 60 patients with choledocholithiasis with acute cholangitis admitted to the Second People´s Hospital of Zhaoqing from April 2016 to October 2021,who were divided into two groups according to treatment methods,with 30 cases in each group.The observation group received percutaneous transhepatic cholangioscopy and balloon lithotripsy treatment,while the control group received percutaneous transhepatic cholangioscopy and lithotripsy treatment.The total postoperative complications,stone clearance rate and perioperative indexes of the two groups were compared.Results The incidence of complications in the observation group(3.33%)was lower than that in the control group(30.00%),and the difference was statistically significant(χ^(2)=7.680,P<0.05).The operative time(96.78±18.33)min,the extraction time of biliary drainage tube(8.15±1.28)d and the anal exhaust time(21.16±3.14)h in the observation group were shorter than those in the control group,and the differences were statistically significant(t=15.295,56.615,10.049,P<0.05).However,there was no statistically significant difference in the time of abdominal drainage tube removal and hospital stay between the two groups(P>0.05).The stone clearance rate in the observation group was 90.00%(27/30),which was higher than that in the control group 60.00%(18/30),and the difference was statistically significant(P<0.05).Conclusion The clinical treatment of common bile duct stones with acute cholangitis can be treated with percutaneous transhepatic cholangioplasty and balloon lithotomy,which can effectively promote perioperative recovery of patients,and has a low incidence of complications and a high stone clearance rate.

关 键 词：胆总管结石 急性胆管炎 经皮肝穿胆管球囊推石术 经皮肝胆道镜取石术 并发症 

分 类 号：R657.42[医药卫生—外科学]