摘要
目的研究两种术式治疗胆管结石患者的效果。方法选取2013年1月～2017年12月我院收治的56例胆总管>1.0 cm的胆管结石患者作为研究对象,按照双盲随机分组原则分为对照组(28例)与观察组(28例)。对照组于消化科行内镜下逆行胰腺管造影(ERCP)取石治疗,观察组于普外科行腹腔镜联合胆道镜取石治疗。比较两组的临床效果、手术时间、术中出血量,术后血淀粉酶、术后出血量以及胰腺炎发生率、术后结石残留、术后疼痛、进食时间、住院时间、术后并发症总发生率。结果观察组患者的临床总有效率高于对照组(P<0.05);观察组患者的手术时间长于对照组,术中出血量少于对照组,术后血淀粉酶低于对照组,差异均有统计学意义(P<0.05);观察组的并发症总发生率低于对照组,差异有统计学意义(P<0.05);两组的术后疼痛评分、进食时间和住院时间比较,差异无统计学意义(P>0.05)。结论腹腔镜联合胆道镜治疗胆总管>1.0 cm的胆管结石患者的效果优于ERCP,可作为临床治疗首选方案。
Objective To study the effect of two surgical procedures in the treatment with calculus of bile duct. Methods A total of 56 patients with calculus of bile duct greater than 1.0 cm treated in our hospital from January 2013 to December 2017 were selected as subjects. They were divided into control group(28 cases)and observation group(28 cases) according to the double-blind randomization principle. The control group was treated with endoscopic retrograde pancreatography (ERCP) for stone removal in the Department of Gastroenterology. The observation group was treated with laparoscopic combined with choledochoscopy in the Department of General Surgery. The clinical effects,operation time,intraoperative blood loss,postoperative blood amylase,postoperative bleeding and incidence of pancreatitis,postoperative residual stones,postoperative pain,eating time,hospital stay,total incidence of postoperative complications were compared between the two groups. Results The total clinical effective rate of patients in the observation group was higher than that of the control group (P<0.05). The operation time of patients in the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,the postoperative blood amylase was lower than the control group,and the differences were statistically significant (P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant (P<0.05). There was no significant difference in postoperative pain scores,eating time and hospitalization time between the two groups (P>0.05). Conclusion Laparoscopic combined with choledochoscopy for the treatment of patients with calculus of bile duct greater than 1.0 cm is superior to ERCP,which can be used as the first choice for clinical treatment.
作者
高绿林
GAO Lv-lin(Department of General Surgery,Ji'an Central People's Hospital,Jiangxi Province,Ji'an 343000,China)
出处
《中国当代医药》
2019年第8期52-54,共3页
China Modern Medicine
关键词
腹腔镜
胆道镜
胆囊切除术
胆总管探查取石
内镜下逆行胰腺管造影
Laparoscopic
Choledochoscopy
Cholecystectomy
Common bile duct exploration
Endoscopic retrograde pancreatography
