腹腔镜胆道镜联合钬激光碎石取石术对肝内外胆管结石的临床疗效分析  

Clinical Analysis of Laparoscopic Choledochoscopy Combined with Holmium Laser Lithotripsy for Intrahepatic and Extrahepatic Bile Duct Stones

作　　者：李永旺[1] 杨建评 郑石勇 LI Yongwang;YANG Jianping;ZHENG Shiyong(Department of General Surgery,Sanming Hospital of Integrated Traditional Chinese and Western Medicine,Sanming,Fujian Province,365001 China)

机构地区：[1]福建省三明市中西医结合医院普外科,福建三明365001

出　　处：《中外医疗》2023年第23期64-67,共4页China & Foreign Medical Treatment

摘　　要：目的探讨腹腔镜胆道镜联合钬激光碎石取石术对肝内外胆管结石的处理效果及血清炎症因子的影响。方法方便选取2020年1月—2022年12月在三明市中西医结合医院就诊的82例胆囊结石及肝内外胆管结石患者为研究对象,按照随机数表法将入选者分成对照组(41例,行开腹胆囊切除胆总管切开及胆道镜取石术),治疗组(41例,行腹腔镜胆囊切除+胆道镜下钬激光碎石取石术)。比较两组临床治疗总有效率,高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)及降钙素原(procalcitonin,PCT)水平。结果治疗组治疗总有效率(100.00%)与对照组(95.12%)对比,差异无统计学意义(χ^(2)=0.513,P>0.05)。干预前,两组hs-CRP、PCT水平比较,差异无统计学意义(P>0.05);干预后,两组hs-CRP较干预前有所提升,PCT水平均下降,治疗组hs-CRP、PCT明显低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜胆道镜联合钬激光碎石取石术是一种安全有效的处理肝内外胆管结石的方法,可明显改善血清炎症指标,有利于患者的康复,值得推广。Objective To investigate the effect of laparoscopic choledochoscopy combined with holmium laser lithotripsy on intrahepatic and extrahepatic bile duct stones and the effect of serum inflammatory factors.Methods 82 patients with gallbladder stones and intrahepatic and extrahepatic bile duct stones who were treated at Sanming Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to December 2022 were conveniently selected as the research subjects.and the selected patients were divided into a control group(41 cases,underwent open cholecystectomy with common bile duct lithotomy and choledocholithotomy)and treatment group(41 cases,underwent laparoscopic cholecystectomy+holmium laser lithotripsy under choledochoscope),according to the random number table,Compared the total effective rate of clinical treatment,as well as the levels of high sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT)between the two groups.Results There was no statistically significant difference in the total effective rate between the treatment group of 100.00%and the control group of 95.12%(χ^(2)=0.513,P>0.05).Before intervention,there was no statistically significant difference in the levels of hs-CRP and PCT between the two groups(P>0.05).After intervention,the hs-CRP levels in the two groups increased compared to before intervention,the PCT levels all decreased,and the hs-CRP and PCT levels in the treatment group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic choledochoscopy combined with holmium laser lithotripsy is a safe and effective method for the treatment of intrahepatic and extrahepatic bile duct stones.It can significantly improve serum inflammatory indicators and is beneficial to the rehabilitation of patients.It is worth promoting.

关 键 词：腹腔镜胆道镜 钬激光碎石 肝内外胆管结石 血清炎症指标 

分 类 号：R5[医药卫生—内科学]