摘要
目的研究胆囊结石合并乙型肝炎病毒感染患者采取腹腔镜胆囊切除联合肝组织切取活检术后应用抗病毒治疗的效果。方法选取44例胆囊结石合并乙型肝炎病毒感染患者,随机分为研究组(26例)和参照组(18例)。研究组采取腹腔镜胆囊切除联合肝组织切取活检术,参照组采取经皮肝脏活组织穿刺术;术后根据肝组织活检病理结果GS分期行抗病毒治疗,分析研究组患者的治疗效果;比较研究组患者治疗前后肝脏炎症程度;比较研究组与参照组并发症发生率、取材阳性情况以及肝活检术手术费用。结果研究组患者的治疗有效率为92.31%(24/26),乙型肝炎E抗原(HBeAg)转阴率为23.08%(6/26),乙肝病毒的脱氧核糖糖核酸(HBV-DNA)转阴率为26.92%(7/26)。研究组患者肝脏炎症程度治疗前轻度0例、中度20例、重度5例、肝硬化1例,治疗后轻度8例、中度16例、重度2例、肝硬化0例;研究组患者治疗后肝脏炎症程度优于治疗前,差异有统计学意义(P<0.05)。研究组术后出血、术后胆漏及气胸发生率低于参照组,取材阳性率高于参照组,但是差异无统计学意义(P>0.05);研究组肝活检术手术费用为(953.65±103.21)元,少于参照组的(4859.98±194.25)元,差异有统计学意义(P<0.05)。结论胆囊结石合并乙型肝炎病毒感染患者采取腹腔镜胆囊切除联合肝组织切取活检术治疗安全、可靠,术后根据肝组织活检病理结果GS分期行抗病毒治疗,整体治疗效果显著。
Objective To study the effect of laparoscopic cholecystectomy combined with liver biopsy on antiviral therapy in patients with gallstones and hepatitis B virus infection.Methods 44 patients with gallstones and hepatitis B virus infection were selected and randomly divided into a study group(26 cases)and a reference group(18 cases).The study group underwent laparoscopic cholecystectomy combined with liver biopsy,and the reference group underwent percutaneous liver puncture biopsy.Antiviral therapy was performed based on the GS staging of liver biopsy pathological results after surgery,and the treatment effect of the study group was analyzed.The degree of liver inflammation before and after treatment was compared in the study group,as well as the incidence of complications,positive sampling and cost of liver biopsy were compared between the study group and the reference group.Results The treatment efficiency in the study group was 92.31%(24/26),the negative-conversion rate of hepatitis B e antigen(HBeAg)was 23.08%(6/26),and the negative-conversion rate of hepatitis B virus deoxyribonucleic acid(HBV-DNA)was 26.92%(7/26).In the study group,the degree of liver inflammation before treatment was mild in 0 cases,moderate in 20 cases,severe in 5 cases,and cirrhosis in 1 case;after treatment,there were 8 mild cases,16 moderate cases,2 severe cases,and 0 cirrhosis cases.The degree of liver inflammation was better than that before treatment in the study group,and the difference was statistically significant(P<0.05).The incidence rates of postoperative bleeding,postoperative bile leakage and pneumothorax in the study group was lower than those in the reference group,and the positive sampling rate was higher than that in the reference group,but the difference was not statistically significant(P>0.05).The cost of liver biopsy was(953.65±103.21)yuan,which was less than(4859.98±194.25)yuan in the reference group,and the difference was statistically significant(P<0.05).Conclusion In patients with gallstones and hepatitis B virus
作者
郭恺
秦红军
胡仁健
支春平
丁严江
GUO Kai;QIN Hong-jun;HU Ren-jian(Leshan Hospital of Traditional Chinese Medicine,Leshan 614000,China)
出处
《中国实用医药》
2024年第16期63-66,共4页
China Practical Medicine
