摘要
目的探讨腹腔镜联合胆道镜微创治疗肝内外胆管结石的临床疗效及安全性。方法随机选取2019年1月—2020年12月该院收治的70例确诊为肝内外胆管结石的患者作为研究对象,前瞻性随机数表法将其分为两组,每组35例,对照组行常规开腹治疗,研究组行腹腔镜联合胆道镜微创治疗,对比两组手术指标、肝功能指标、并发症率以及免疫功能指标。结果研究组术中出血情况(311.76±28.23)mL、术后肛门排气时间(15.23±2.76)h、住院时间(9.02±2.09)d,所需治疗费用(2.31±0.31)万元,均低于对照组患者,差异有统计学意义(t=26.688、10.397、7.151、11.049,P<0.001),但两组手术时间、结石复发情况[(176.54±32.34)min vs(183.54±20.65)min,8.57%vs 5.71%]对比,差异无统计学意义(P>0.05)。术前两组患者肝功能对比,差异无统计学意义(P>0.05),干预后研究组患者ALT、TBIL低于对照组[(7.54±1.08)U/L vs(40.62±2.12)U/L,(17.65±1.75)μmol/L vs(25.76±4.32)μmol/L],差异有统计学意义(P<0.001)。研究组并发症发生率低于对照组(11.43%vs 34.29%),差异有统计学意义(P<0.05)。术前两组患者免疫指标对比,差异无统计学意义(P>0.05),干预后研究组CD4^(+)、CD8^(+)、IgG、IgA、IgM均高于对照组,差异有统计学意义(t=24.580、30.244、4.492、2.670、3.391,P<0.001)。结论腹腔镜联合胆道镜微创治疗肝内外胆管结石术可促进患者康复效果,缩短术后恢复时间,提升患者免疫功能,保护患者的肝功能,是一种安全可靠的干预手术方案。
Objective To investigate the clinical efficacy and safety of laparoscopic combined with choledochoscope for minimally invasive treatment of intra-and extrahepatic bile duct stones.Methods Selected randomly 70 patients diagnosed with intrahepatic bile duct stones in the hospital from January 2019 to December 2020 as the research objects,and divided them into two groups by prospective random number table method,each with 35 cases,control group underwent conventional laparotomy,and the study group underwent laparoscopy combined with choledochoscopy minimally invasive treatment.The operation indexes,liver function indexes,complication rate and immune function indexes were compared between the two groups.Results In the study group,intraoperative bleeding(311.76±28.23)mL,postoperative anal exhaust time(15.23±2.76)h,hospitalization time(9.02±2.09)d,required treatment cost(2.31±0.31)ten thousand yuan,both lower than those in the control group,the difference was statistically significant(t=26.688,10.397,7.151,11.049,P<0.001).However,there was no statistically significant difference in operation time and stone recurrence between the two groups[(176.54±32.34)min vs(183.54±20.65)min,8.57%vs 5.71%](P>0.05).There was no significant statistical difference in liver function between the two groups before surgery(P>0.05).After the intervention,the ALT and TBIL of the study group were lower than those of the control group[(7.54±1.08)U/L vs(40.62±2.12)U/L,(17.65±1.75)μmol/L vs(25.76±4.32)μmol/L],the difference was statistically significant(P<0.001).The incidence of complications in the study group was lower than that in the control group(11.43%vs 34.29%),and the difference was statistically significant(P<0.05).There was no significant statistical difference in immune indexes between the two groups of patients before operation(P>0.05).After intervention,the CD4^(+),CD8^(+),IgG,IgA,IgM of the study group were higher than those of the control group,and the difference was statistically significant(t=24.580,30.244,4.492,2.670
作者
杨起健
YANG Qijian(Department of General Surgery,Nanping People's Hospital,Nanping,Fujian Province,353000 China)
出处
《中外医疗》
2021年第35期75-79,共5页
China & Foreign Medical Treatment
关键词
腹腔镜
胆道镜
微创治疗
肝内外胆管结石
临床疗效
安全性
Laparoscopy
Choledochoscopy
Minimally invasive treatment
Intrahepatic and extrah epatic bile duct stones
Clinical efficacy
Safety
