胆道镜钬激光碎石术联合肝叶切除术治疗复杂性肝内胆管结石患者的临床疗效分析  

Clinical Analysis of Choledochoscopic Holmium Laser Lithotripsy Combined with Hepatectomy in the Treatment of Complex Intrahepatic Bile Duct Calculi

作　　者：潘伟华[1] PAN Weihua(Department of Hepatological Surgery,Longyan Second Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]龙岩市第二医院肝胆外科,福建龙岩364000

出　　处：《中外医疗》2023年第9期63-66,71,共5页China & Foreign Medical Treatment

摘　　要：目的探究胆道镜钬激光碎石术联合肝叶切除术治疗复杂性肝内胆管结石患者的临床疗效。方法随机选取2018年4月—2022年4月于龙岩市第二医院肝胆外科收治的65例复杂性肝内胆管结石患者作为研究对象,其中32例患者采取胆管镜取石与肝叶切除术,纳入对照组,33例患者采取胆道镜钬激光碎石术联合肝叶切除术,纳入观察组,比较两组患者治疗情况、并发症、复发情况和术后不同程度的疼痛评分。结果观察组术中出血量、治疗费用和住院时间均优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率和半年内结石复发率分别为9.09%、6.06%,均低于对照组的31.38%、28.13%,差异有统计学意义(χ^(2)=6.145、5.625,P<0.05);观察组术后12、24、48h疼痛评分,均低于对照组,差异有统计学意义(P<0.05)。结论胆道镜钬激光碎石术联合肝叶切除术治疗复杂性肝内胆管结石,不仅能减少患者术中出血量,还能有效降低其并发症发生率和缓解术后疼痛,且缩短住院时间,减少患者的治疗费用,半年内复发率极低,证实手术的有效性。Objective To explore the clinical effect of choledochoscopic holmium laser lithotripsy combined with hepatectomy in the treatment of complex intrahepatic bile duct calculi.Methods Sixty-five patients with complex intrahepatic bile duct stones admitted to the Department of Hepatobiliary Surgery of Longyan Second Hospital from April 2018 to April 2022 were randomly selected as analysis objects.Thirty-two patients underwent cholestroscopy and hepatectomy and were included in the control group.Thirty-three patients underwent choledochoscopic holmium laser lithotripsy combined with hepatectomy and were included in the observation group.The treatment,complications,recurrence and postoperative pain scores of the two groups were compared.Results The intraoperative blood loss,treatment cost and hospital stay in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).The complication rate and recurrence rate of stone in the observation group were 9.09%and 6.06%,respectively,which were lower than 31.38%and 28.13%in the control group,and the difference was statistically significant(χ^(2)=6.145,5.625,P<0.05).The pain scores of the observation group at 12 h,24 h and 48 h after surgery were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Choledochoscopic holmium laser lithotripsy combined with hepatectomy in the treatment of complex intrahepatic bile duct stones can not only reduce the amount of intraoperative blood loss,but also effectively reduce the incidence of complications and relieve postoperative pain,shorten the length of hospital stay,reduce the treatment cost of patients,and the recurrence rate within half a year is extremely low,which confirms the effectiveness of the operation.

关 键 词：胆道镜钬激光碎石术 肝叶切除术 复杂性肝内胆管结石 临床疗效 

分 类 号：R657[医药卫生—外科学]