探讨腹腔镜联合纤维胆道镜治疗肝内外胆管结石的效果  

The effect of laparoscopy combined with choledochoscope in the treatment of intrahepatic and extrahepatic bile duct stones

作　　者：谢俊峰 邓伦钦 XIE Jun-feng;DENG Lun-qin(Department of Surgery,Shaowu Municipal Hospital,Shaowu 354000,China)

机构地区：[1]邵武市立医院肝胆胰脾疝外科,354000

出　　处：《中国现代药物应用》2024年第23期37-40,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究腹腔镜联合纤维胆道镜治疗肝内外胆管结石的效果。方法选取64例肝内外胆管结石患者,随机分成对照组及研究组,各32例。对照组接受开腹胆总管切开取石术治疗,研究组接受腹腔镜联合纤维胆道镜手术治疗。对比两组手术指标(手术时间、术中出血量、术后肠道排气时间、住院时间),血常规指标[白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞绝对值(N)]及CRP水平,术后并发症发生情况。结果研究组手术时间(93.8±8.9)min、术后肠道排气时间(1.8±0.7)d、住院时间(7.2±2.0)d短于对照组的(111.9±9.8)min、(3.3±1.0)d、(10.8±1.3)d,术中出血量(30.3±2.4)ml少于对照组的(51.3±3.3)ml(P<0.05)。研究组的WBC、N、PLT、CRP水平分别为(11.2±1.1)×10^(9)/L、(2.1±0.4)×10^(9)/L、(120.4±9.6)×10^(9)/L、(10.5±2.8)mg/L,低于对照组的(13.5±2.4)×10^(9)/L、(3.8±1.2)×10^(9)/L、(158.9±10.4)×10^(9)/L、(14.0±3.4)mg/L(P<0.05)。研究组术后并发症发生率12.5%低于对照组的34.4%(P<0.05)。结论肝内外胆管结石治疗期间,腹腔镜联合纤维胆道镜的应用可以优化各项手术指标,大幅度降低机体内的CRP水平并改善各项血常规指标,进而降低术后并发症发生率,效果显著。Objective To explore the effect of laparoscopy combined with choledochoscope in the treatment of intrahepatic and extrahepatic bile duct stones.Methods A total of 64 patients with intrahepatic and extrahepatic bile duct stones were randomly divided into a control group and a study group,with 32 cases in each group.The control group was treated with open choledocholithotomy,and the study group was treated with laparoscopy combined with choledochoscope.Comparison was made on surgical indexes(operation time,intraoperative blood loss,postoperative exhaust time,length of hospital stay),routine blood indexes[white blood cell count(WBC),platelet count(PLT),neutrophils(N)]and CRP levels,and the incidence of postoperative complications between the two groups.Results In the study group,the operation time was(93.8±8.9)min,the postoperative exhaust time was(1.8±0.7)d and the length of hospital stay was(7.2±2.0)d,which were shorter than(111.9±9.8)min,(3.3±1.0)d and(10.8±1.3)d in the control group;the intraoperative blood loss of(30.3±2.4)ml in the study group was less than(51.3±3.3)ml in the control group(P<0.05).The levels of WBC,N,PLT and CRP in the study group were(11.2±1.1)×10^(9)/L,(2.1±0.4)×10^(9)/L,(120.4±9.6)×10^(9)/L and(10.5±2.8)mg/L,which were lower than(13.5±2.4)×10^(9)/L,(3.8±1.2)×10^(9)/L,(158.9±10.4)×10^(9)/L and(14.0±3.4)mg/L in the control group(P<0.05).The incidence of postoperative complications of 12.5%in the study group was lower than 34.4%in the control group(P<0.05).Conclusion During the treatment of intrahepatic and extrahepatic bile duct stones,the application of laparoscopy combined with choledochoscope can optimize the surgical indexes,drastically reduce the CRP level and improve the blood routine indexes,thus reducing the incidence of postoperative complications,with remarkable effects.

关 键 词：腹腔镜 纤维胆道镜 肝内外胆管结石 手术指标 血清炎症因子水平 术后并发症 

分 类 号：R657.42[医药卫生—外科学]