胆管结石应用腹腔镜联合胆道镜取石术及利胆排石颗粒治疗的远期效果分析  

Analysis of the long-term effect of combined laparoscopic and choledochoscopic lithotomy and Lidan Paishi granules in the treatment of bile duct stones

作　　者：沙聪[1] 张一心 袁爱军[1] 吴仁极 SHA Cong;ZHANG Yi-xin;YUAN Ai-jun(Department of Hepatobiliary Surgery,Nantong Ruici Hospital,Nantong 226009,China)

机构地区：[1]江苏省南通瑞慈医院肝胆外科,226009

出　　处：《中国实用医药》2023年第24期100-103,共4页China Practical Medicine

摘　　要：目的分析胆管结石应用腹腔镜联合胆道镜取石术及利胆排石颗粒治疗的远期效果。方法72例胆管结石患者,随机分为对照组和观察组,各36例。对照组应用腹腔镜联合胆道镜取石术治疗,观察组在对照组基础上加用利胆排石颗粒治疗。对比两组治疗6和12个月后最大结石直径、胆结石残留率、胆管狭窄率、临床症状(上腹疼痛、黄疸及发热)发生率及治疗12个月后的效果。结果观察组治疗6、12个月后最大结石直径分别为(3.84±1.08)、(3.12±0.86)mm,均小于对照组的(4.52±1.25)、(4.56±1.27)mm,差异有统计学意义(P<0.05)。观察组治疗6、12个月后胆结石残留率和胆管狭窄率分别为16.67%、25.00%和11.11%、19.44%,均低于对照组的38.89%、50.00%和30.56%、44.44%,差异有统计学意义(P<0.05)。两组治疗6个月后黄疸、发热发生率对比,差异无统计学意义(P>0.05);观察组治疗6、12个月后上腹疼痛发生率分别为8.33%、13.89%,均低于对照组的27.78%、36.11%,差异有统计学意义(P<0.05);观察组治疗12个月后黄疸、发热发生率分别为2.78%、5.56%,均低于对照组的22.22%、27.78%,差异有统计学意义(P<0.05)。观察组治疗12个月后总有效率94.44%高于对照组的77.78%,差异有统计学意义(P<0.05)。结论胆管结石应用腹腔镜联合胆道镜取石术及利胆排石颗粒治疗能有效降低胆结石残留率及胆管狭窄率,缩小结石直径,进而改善患者临床症状,提升远期治疗效果。Objective To analyze the long-term effect of combined laparoscopic and choledochoscopic lithotomy and Lidan Paishi granules in the treatment of bile duct stones.Methods A total of 72 patients with cholangiolithiasis were randomly divided into a control group and an observation group,with 36 cases in each group.The control group was treated with combined laparoscopic and choledochoscopic lithotomy,and the observation group was treated with Lidan Paishi granule on the basis of the control group.Both groups were compared in terms of maximum stone diameter,residual gallstone rate,bile duct stenosis rate after 6 and 12 months of treatment,incidence of clinical symptoms(epigastric pain,jaundice and fever)and the effect after 12 months of treatment.Results After 6 and 12 months of treatment,the maximum stone diameters in the observation group were(3.84±1.08)and(3.12±0.86)mm,which were smaller than those of(4.52±1.25)and(4.56±1.27)mm in the control group,and the differences were statistically significant(P<0.05).After 6 and 12 months of treatment,the residual gallstone rate,bile duct stenosis rate in the observation group were 16.67%,25.00%and 11.11%,19.44%,which were lower than those of 38.89%,50.00%and 30.56%,44.44%in the control group.The differences were statistically significant(P<0.05).After 6 months of treatment,there was no statistically significant difference in the incidence of jaundice and fever between the two groups(P>0.05).After 6 and 12 months of treatment,the incidence of epigastric pain in the observation group were 8.33%and 13.89%,which were lower than those of 27.78%and 36.11%in the control group,and the differences were statistically significant(P<0.05).After 12 months of treatment,the incidence of jaundice and fever in the observation group were 2.78%and 5.56%,which were lower than those of 22.22%and 27.78%in the control group,and the differences were statistically significant(P<0.05).After 12 months of treatment,the total effective rate of 94.44%in the observation group was higher than that of 7

关 键 词：胆管结石 腹腔镜 胆道镜 取石术 利胆排石颗粒 胆结石残留率 胆管狭窄率 

分 类 号：R657.4[医药卫生—外科学]