摘要
目的 探析开腹、腔镜、钬激光等三种手术方式治疗难取性肝内外胆管结石的效果。方法 选取100例难取性肝内外胆管结石患者,采用随机数字表法将其分为开腹组、腔镜组及钬激光组,开腹组患者采用开腹下胆总管切开探查取石术治疗,腔镜组患者采用腹腔镜联合胆道镜下胆总管探查取石术治疗,钬激光组患者采用腹腔镜联合胆道镜钬激光碎石术治疗。比较3组临床疗效、围术期相关指标及术后并发症情况。结果 与开腹组和腔镜组比较,钬激光组结石完全取净患者占比明显更高(P<0.05);钬激光组手术时间与术后排气时间明显更短,术中出血量明显更低(P<0.05);钬激光组出现并发症的概率明显更低(P<0.05)。结论 对难取性肝内外胆管结石患者采用钬激光手术治疗可获得较好的效果,与开腹手术和腔镜手术相比,可有效缩短手术时间与术后排气时间,降低术中出血量,且患者术后并发症少,具有较高的临床推广价值。
Objective To explore the effect of laparotomy,endoscopy and holmium laser in the treatment of refractory intrahepatic and extrahepatic bile duct stones. Methods 100 patients with intractable intrahepatic and extrahepatic bile duct stones were randomly divided into laparotomy group,endoscopic group and holmium laser group. The patients in laparotomy group were treated with laparotomy combined with choledochoscopy,The patients in the holmium laser group were treated with laparoscopy combined with choledochoscopic holmium laser lithotripsy. The clinical efficacy,perioperative related indexes and postoperative complications of the three groups were compared. Results After different surgical treatments,the proportion of patients with complete stone removal in holmium laser group was significantly higher than that in laparotomy group and Endoscopy Group(P<0.05);In holmium laser group,the operation time and postoperative exhaust time were significantly shorter,and the amount of intraoperative bleeding was significantly lower(P<0.05);The incidence of complications in holmium laser group was significantly lower(P<0.05).Conclusion Holmium laser surgery for patients with refractory intrahepatic and extrahepatic bile duct stones can obtain better therapeutic effect. Compared with laparotomy and endoscopic surgery,it can effectively shorten the operation time and postoperative exhaust time,reduce the amount of intraoperative bleeding,and have less postoperative complications. It has high clinical value.
作者
王海平
Wang Haiping(The Wuhuaqinjiang Hospital of Meizhou City,Meizhou,Guangdong 514000)
出处
《基层医学论坛》
2022年第4期5-7,共3页
The Medical Forum
基金
河源市科技计划项目(河科083)。
关键词
难取性肝内外胆管结石
开腹手术
腹腔镜/胆道镜
钬激光
疗效对比
Intractable intrahepatic and extrahepatic bile duct stones
Laparotomy
Laparoscope/Choledochoscopy
Holmium laser
Effect comparison
