腹腔镜下胆道镜联合液电碎石术对肝内胆管结石的疗效及对炎性应激反应指标、预后的影响  

Efficacy of Laparoscopic Choledochoscopy Combined with Liquid-Electric Lithotripsy in Intrahepatic Bile Duct Stones and its Influence on Inflamma⁃tory Stress Response Index and Prognosis

作　　者：黎涛[1] 王雪梅 李克跃[1] 石承先[1] LI Tao;WANG Xueme;LI Keyue;SHI Chengxian(Department of Hepatobiliary Surgery,Guizhou Provincial People′s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院肝胆外科,贵州贵阳550002

出　　处：《系统医学》2025年第1期134-137,共4页Systems Medicine

摘　　要：目的探讨腹腔镜下胆道镜联合液电碎石术治疗肝内胆管结石的疗效及对炎性应激反应指标、预后的影响。方法非随机选取2020年12月—2023年12月贵州省人民医院收治的100例肝内胆管结石患者为研究对象,按治疗方法不同分为两组,每组50例,对照组进行经皮经肝穿刺胆道镜取石术,观察组进行腹腔镜下胆道镜联合液电碎石术。比较两组结石清除效果、并发症发生情况、复发情况、手术治疗指标应激反应及炎症反应指标水平。结果观察组的治疗总有效率比对照组高,差异有统计学意义(P<0.05);两组术后6个月复发率比较,差异无统计学意义(P>0.05)。观察组并发症发生率为4.00%(2/50),比对照组的18.00%(9/50)低,差异有统计学意义(χ^(2)=5.005,P<0.05)。观察组术中出血量比对照组少,手术时间、肛门排气时间、住院时间比对照组短,肾上腺素、皮质醇、C反应蛋白、肿瘤坏死因子α水平比对照组低,差异有统计学意义(P均<0.05)。结论肝内胆管结石患者采取腹腔镜下胆道镜联合液电碎石术治疗可取得良好的结石清除效果,复发率较低,创伤小、恢复快,并发症少,而且术后应激反应及炎症反应轻,治疗价值较高。Objective To investigate the efficacy of laparoscopic choledochoscopy combined with liquid electrolitho⁃tripsy for intrahepatic bile duct stones and its effect on inflammatory stress response index and prognosis.Methods 100 patients with intrahepatic bile duct stones in the Guizhou Provincial People′s Hospital fom December 2020 to De⁃cember 2023 were non-randomly selected as the research objects.They were divided into two groups according to the different treatment methods with 50 cases in each group,the control group was treated with percutaneous,and the ob⁃servation group was treated with laparoscopic chololedochoscope combined with liquid-electric lithotripsy.The stone clearance effect,occurence of complications,recurrence,surgical treatment indicators,stress response and inflamma⁃tory response indicators were compared between the two groups.Results The total treatment response rate in the obser⁃vation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the recurrence rate between two groups(P>0.05).The complication rate in the observation group was 4.00%(2/50),lower than 18.00%(9/50)in the control group,and the difference was statisti⁃cally significant(χ^(2)=5.005,P<0.05).The operation time,intraoperative bleeding volume,anal exhaust time,and hospi⁃tal stay were lower than those the control group,the level of E,Cor,CRP,and TNF-αwere lower than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion For patients with intrahepatic bile duct stones,low recurrence rate,less trauma,quick recovery,fewer complications,and mild postoperative stress and inflammation, with high therapeutic value.

关 键 词：肝内胆管结石 腹腔镜 胆道镜 液电碎石术 应激反应 炎症反应 

分 类 号：R4[医药卫生—临床医学]