胆道结石术后经T管窦道胆道镜联合液电碎石术治疗残留结石的效果分析  

Effect of T-tube Sinus Choledochoscopy Combined with Electro-hydraulic Lithotripsy in the Treatment of Residual Stones after Biliary Calculi Operation

作　　者：彭鹏 刘修元 杨林 PENG Peng;LIU Xiuyuan;YANG Lin(Department of General Surgery,Xuzhou Mining Hospital,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州市矿山医院普外科,江苏徐州221000

出　　处：《系统医学》2024年第8期145-147,158,共4页Systems Medicine

摘　　要：目的分析胆道结石术后经T管窦道胆道镜联合液电碎石术治疗残留结石的效果。方法选取2019年7月—2023年7月徐州市矿山医院收治的50例胆道结石术后结石残留患者进行研究,按随机数表法分为对照组(n=25)和研究组(n=25),对照组行开腹手术,研究组行经T管窦道胆道镜联合液电碎石术,比较两组手术指标(手术时间、出血量、住院时间)、结石取净率及并发症情况。结果研究组手术时间(182.57±19.38)min长于对照组,差异无统计学意义(P>0.05);出血量(15.37±4.35)mL、住院时间(6.12±2.21)d均短于对照组,差异有统计学意义(P均<0.05);研究组结石取净率92.00%高于对照组,差异有统计学意义(χ^(2)=4.500,P<0.05);研究组取石治疗过程中出现术后发热1例,而对照组出现胆道出血2例,胰腺炎1例,术后发热4例,总并发症发生率高于研究组,差异有统计学意义(P<0.05)。结论经T管窦道胆道镜联合液电碎石术治疗胆道结石术后残留结石虽耗时较长,但创伤较小,结石取净率高,并发症发生率低,疗效明确,是一种安全有效的治疗方法。Objective To analyze the effect of T-tube sinus choledochoscopy combined with electro-hydraulic lithotripsy in the treatment of residual stones.Methods A total of 50 patients with residual biliary stones after operation treated by Xuzhou Mining Hospital from July 2019 to July 2023 were selected for study,and were divided into control group(n=25)and study group(n=25)by random number table method.The control group underwent laparotomy,and the study group underwent T-tube sinus choledochoscopy combined with electro-hydraulic lithotripsy.The surgical indexes(operation time,blood loss,hospital stay),stone removal rate and complications were compared between the two groups.Results The operation time of the study group(182.57±19.38)min was longer than that of the control group,and the difference was not statistically significant(P>0.05).The amount of blood loss(15.37±4.35)mL and the length of hospitalization(6.12±2.21)d were shorter than those in the control group,and the differences were statistically significant(both P<0.05).The stone removal rate was 92.00%of the study group,higher than that of control group,and the difference was statistically significant(χ^(2)=4.500,P<0.05).In the study group,postoperative fever occurred in 1 case,while in the control group,biliary tract hemorrhage occurred in 2 cases,pancreatitis occurred in 1 case and postoperative fever occurred in 4 cases,the total complication rate was higher than that in the study group,and the difference was statistically significant(P<0.05).Conclusion Although it takes a long time to treat residual stones after biliary calculus,the combined treatment of T-tube sinus choledochoscopy and electro-hydraulic lithotripsy is a safe and effective treatment method with less trauma,high stone removal rate,low complication rate and clear curative effect.

关 键 词：胆道结石 T管窦道 液电碎石术 胆道镜 

分 类 号：R657.4[医药卫生—外科学]