摘要
目的 探析对比胆总管结石开腹手术(OCHTD)与胆囊原位内镜下括约肌切开术(EST)临床价值。方法 选择2019年3月—2021年3月本院收治的89例胆囊结石后继发胆总管结石(CBDS)患者作为研究对象,随机分为对照组(43例)和观察组(46例)两组。对照组实施OCHTD,观察组于胆囊原位实施EST治疗,比较两组手术相关治疗指标、操作成功率、结石清除及复发率、括约肌功能指标(袖套式Oddi括约肌压力测定法(SOM)检测胆管压(CBDP)、收缩幅度(SOCA)以及收缩频率(SOF))、术式治疗安全性。结果 观察组手术、术后首次排气、康复住院时间及术中出血量、并发症发生率均明显低于对照组(P<0.05)。两组治疗前后括约肌功能指标(CBDP、SOCA、SOF)组间对比无统计学差异(P>0.05)。结论 胆囊原位EST治疗胆囊结石后继发CBDS临床效果显著,与OCHTD具有相近结石清除率、复发率、操作成功率,不易对括约肌功能造成严重损伤,且可以有效缩短手术及康复时间,降低术中出血量,提高手术治疗效率及安全性,值得临床推广。
Objective To compare the clinical values of open choledocholithiasis(OCHTD)and in situ endoscopic sphincterotomy(EST).Methods Eighty-nine patients with CBDS secondary to gallstones who visited Minquan county people’s hospital from March 2019 to March 2021 were selected as study objects,and they were randomly divided into a control group(n=43 cases)and an observation group(n=46 cases).The control group was treated with OCHTD,and the observation group was treated with EST in situ of the gallbladder.The operation-related indicators,operation success rate,stone removal and recurrence rate,sphincter function indicators(the pressure of bile duct(CBDP),contraction amplitude(SOCA)and contraction frequency(SOF)detected by sleeve type Oddi sphincter pressure measurement(SOM))and the operation safety were compared between the two groups.Results The operation,time to first postoperative exhaust,rehabilitation hospitalization time,intraoperative blood loss,and complication rate of observation group were significantly lower than those of the control group(P<0.05).There was no statistical difference between the two groups in sphincter function indexes(CBDP,SOCA,SOF)before and after treatment(P>0.05).Conclusions Situ gallbladder EST has significant clinical effect in treating CBDS secondary to gallstones.It is similar to OCHTD in stone clearance rate,recurrence rate and operation success rate,and not easy to cause serious injury to sphincter function,and it could effectively shorten operation and rehabilitation time,reduce intraoperative blood loss,improve operation efficiency and safety,and is worthy of clinical promotion.
作者
王建民
Wang Jianmin(Minquan county people's hospital,Shangqiu,Henan,476800,China)
出处
《齐齐哈尔医学院学报》
2022年第9期838-841,共4页
Journal of Qiqihar Medical University
