双镜联合胆总管探查术后序贯液电碎石术在胆总管结石中的应用

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (0 KB) HTML (31 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨双镜联合胆总管探查术后序贯液电碎石术对胆总管结石患者一次性结石取净率及恢复的影响。方法选取2019年2月～2020年2月沈阳市第四人民医院收治的67例胆总管结石患者作为研究对象，按照随机数字表法分为对照组（33例）与观察组（34例）。对照组采用双镜联合胆总管探查方法，观察组采用双镜联合胆总管探查术后序贯液电碎石术方法。比较两组的一次性结石取净率、白细胞计数（WBC）、总胆红素（TBil）、谷氨酰转肽酶（GGT）水平情况及并发症发生情况。结果两组手术均顺利完成且结石取净率为100%；观察组的术中出血量少于对照组，手术、胆管出血、排气及住院时间均短于对照组，差异有统计学意义（P<0.05）；术后观察组的WBC、TBil、GGT水平低于对照组，差异有统计学意义（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）。结论双镜联合胆总管探查术后序贯液电碎石术对胆总管结石患者治疗效果显著，可彻底清除结石，降低WBC、TBil 水平，且无并发症增加，促进术后恢复，值得借鉴。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	纪来伟
	孙铎
	宋铎
	姜德帅

关键词 ：胆总管结石, 双镜, 序贯液电碎石术, 结石取净率, 恢复

Abstract：Objective To explore the effect of sequential electrohydraulic lithotripsy after bimirror combined with common bile duct exploration on the one-time caculus removal rate and recovery of patients with choledocholithiasis.Methods A total of 67 patients with choledocholithiasis treated in Shenyang Fourth People′s Hospital,Liaoning Province from February 2019 to February 2020 were selected as the research objects.According to the random number table method,they were divided into control group (33 cases) and an observation group (34 cases).The control group adopted bimirror combined with common bile duct exploration method,the observation group adopted sequential electrohydraulic lithotripsy after bimirror combined common bile duct exploration.The one-time caculus removal rate,white blood cell count (WBC),total bilirubin (TBil),glutamyl transpeptidase (GGT) levels improvement and complications were compared between the two groups.Results The operations in the two groups were successfully completed and the caculus removal rate was 100%;the intraoperative blood loss of the observation group was less than that of the control group,and the time of operation,biliary bleeding,exhaust and hospitalization time were shorter than those of the control group,the differences were statistically significant (P<0.05);the WBC,TBil,and GGT levels of the observation group after surgery were lower than those of the control group,the differences were statistically significant (P<0.05);the total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant (P<0.05).Conclusion Sequential electrohydraulic lithotripsy after bimirror combined with common bile duct exploration for patients with choledocholithiasis has a significant effect,which can completely remove the calculus and decrease WBC,TBil levels,and there is no obvious increase in complications,and is worth learning from.

Key words： Choledocholithiasis Himirror Sequential electrohydraulic lithotripsy Caculus removal rate Rrecovery

作者简介: 纪来伟（1985-），男，山东泰安人，硕士，主治医师，研究方向：肝胆胰外科疾病的微创及综合治疗

引用本文:

纪来伟；孙铎；宋铎；姜德帅. 双镜联合胆总管探查术后序贯液电碎石术在胆总管结石中的应用[J]. 中国当代医药, 2021, 28(4): 92-94转98.
JI Lai-wei ；SUN Duo； SONG Duo ；JIANG De-shuai. Application of sequential electrohydraulic lithotripsy in choledocholithiasis after bimirror combined with common bile duct exploration. 中国当代医药, 2021, 28(4): 92-94转98.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I4/92

[1]	卿哲，段键，夏仁品，等.双镜联合经胆囊管胆总管探查术的临床应用[J].腹腔镜外科杂志，2018，23（8）：609-612.
[2]	张志伟，尹昌生，荆信彬，等.腹腔镜联合胆管镜胆总管探查取石术后一期缝合效果观察[J].山东医药，2018，58（48）：63-65.
[3]	胥丹，胡晋太，韩保俊，等.液电碎石在微创手术治疗胆总管结石中使用时机的探讨[J].中国现代手术学杂志，2019，23（4）：255-259.
[4]	冯爱芳，程亚丽，郑鑫，等.双镜联合微创手术与开腹手术治疗胆道结石术后疼痛及预后对照研究[J].陕西医学杂志，2017，46（9）：1235-1236.
[5]	吴孟超，吴在德.黄家驷外科学（7版）[J].中国医刊，2009，44（6）：50.
[6]	王博林，王塬，齐亚刚，等.两种双镜联合微创术式治疗胆总管结石的临床对比研究[J].腹腔镜外科杂志，2019，24（4）：285-288.
[7]	肖家全，张勇.双镜联合治疗胆总管结石的临床应用[J].中国临床实用医学，2016，7（6）:37-40.
[8]	程晓剑，侯亚峰，章健，等.腹腔镜联合胆道镜治疗胆总管结石的疗效与安全性分析[J].安徽医药，2017，21（10）：1837-1840.
[9]	黄阿方，陈秋强.双镜联合经胆囊管胆总管探查取石术治疗胆总管结石的临床研究[J].浙江创伤外科，2015，5（1）：150-151.
[10]	赵培忠.腹胆双镜下胆囊切除联合胆总管探查取石一期缝合术治疗胆总管结石合并胆囊结石的疗效观察[J].贵州医药，2018，42（4）：49-50.
[11]	余海波，董亚东，田广金，等.腹腔镜联合胆道镜胆总管探查术治疗复发性胆总管结石疗效观察[J].中华实用诊断与治疗杂志，2019，33（5）：458-460.
[12]	李超，汪宏，刘玉海，等.双镜联合胆总管探查术胆管自脱落支架置入与T 管引流的临床疗效比较[J].肝胆外科杂志，2019，27（2）：112-115.
[13]	蒋磊，褚亮，张杰，等.双镜联合治疗胆囊结石合并胆总管结石的临床疗效[J].安徽医学，2017，39（3）：331-333.
[14]	石奎，付军，姜新春，等.双镜联合治疗胆囊结石并胆总管结石的效果及安全性分析[J].贵州医药，2018，42（3）：306-307.
[15]	孟祥涛，刘庆拿.双镜联合对胆总管结石患者的疗效分析[J].中国现代普通外科进展，2018，21（8）：628-629.