摘要
目的分析规则性肝切除术联合胆管镜在肝内胆管结石治疗中的价值。方法将94例复杂性肝内胆管结石患者随机分为观察组和对照组各47例。观察组行规则性肝切除术联合胆管镜治疗,对照组行多肝叶切除术联合胆管镜治疗,观察两组治疗效果及肝叶切除情况,比较手术前后肝功能指标的变化,并记录术后并发症发生情况。结果观察组优良率高达95.74%,明显高于对照组的78.72%(P<0.05);在肝叶切除方面,两组未见显著差异(P>0.05)。与术前1 d比较,两组术后7d丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及总胆红素(TBIL)水平均明显降低(P<0.01),而白蛋白(ALB)、凝血酶原时间(PT)未见明显变化(P>0.05)。观察组术后并发症总发生率为14.89%,结石残余率为6.38%,明显低于对照组的33.33%和21.28%(P<0.05)。结论规则性肝切除术联合胆管镜治疗肝内胆管结石疗效显著,可有效减少术后并发症和结石残余的发生,值得临床上推广应用。
OBJECTIVE To analyze the value of regular hepatectomy combined with choledochoscope in the treatment of intrahepatic chalangiocarcinoma. METHODS Totally 94 patients with complicated intrahepatic chalangiocarcinoma were randomly divided into ob- servation group（n=47） and control group（n=47）. The patients in observation group were treated with regular hepatectomy combined with choledochoscope, while those in control group with multiple hepalobectomy combined with choledochoseope. The therapeutic ef- fect and condition of hepatic lobes were observed in two groups, the changes of liver function indexes were compared before and after surgery, and the incidence of postoperative complications were recorded. RESULTS The excellent rate （95.74%） in observation group was markedly higher than 78.72% in control group （P〈O.05）. No significant difference showed between two groups regarding the con- dition of hepatic lobes （P〉0.05）. Compared with 1 d before surgery, the levels of alanine aminotransferase （ALT）, aspartic transami- nase （AST） and total bilirubin （TBIL） fell down dramatically（P〈0.01）, whereas those of albumin （ALB） and prothrombin time （PT） had no obvious change 7 d after surgery in both groups（P〉0.05）. The incidence of postoperative complications and residual rate of stones in observation group were 14.89% and 6.38%, significantly lower than 33.33% and 21.28% in control group （P〈0.05）. CON- CLUSION For intrahepatic chalangiocarcinoma, regular hepatectomy combined with choledochoscope could effectively reduce postop- erative complications and occurrence of stone residue, with significant efficacy, so it deserved to be popularized and applied in clinic.
出处
《中国初级卫生保健》
2018年第2期92-94,共3页
Chinese Primary Health Care
关键词
肝内胆管结石
规则性肝切除术
胆管镜
肝功能
并发症
intrahepatic chalangiocarcinoma
regular hepatectomy
choledochoscope
liver function
complication
