CAJ | 학술논문

目的探讨EMS第三代超声波弹道碎石清石系统治疗胆石症的可行性与效果.方法对EMS第三代超声波弹道碎石清石系统与腹腔镜及经皮肾镜/输尿管镜联合应用治疗24例胆石症临床资料分析.结果 6例保胆手术患者,均1次取石成功.腹腔镜胆总管探查手术12例术中1次取尽结石,4例中转开放手术1次取尽结石,仅2例结石无法一次取尽,1个月后,用同样方法再次取石,全部取尽.本组患者超声碎石取石成功率100%,手术时间90～240min,平均165min.住院时间5～10天,平均7.5天,术中出血量50～100 ml.术后未发生感染、出血或胆漏等并发症.24例患者均在术后2～12个月来院复查,B超检查提示保胆手术患者的胆囊收缩功能良好,胆囊壁无水肿,肝内外胆管未见结石复发.结论恰当选择超声探针与经皮肾镜/输尿管镜搭配,EMS第三代超声波弹道碎石清石系统与腹腔镜联合应用治疗胆石症,能取得比较好的效果,而且操作简单、术中出血量少、手术时间较短、病人痛苦小、术后不良反应少.
목적 탐토EMS제삼대초성파탄도쇄석청석계통치료담석증적가행성여효과.방법 대EMS제삼대초성파탄도쇄석청석계통여복강경급경피신경/수뇨관경연합응용치료24례담석증림상자료분석.결과 6례보담수술환자,균1차취석성공.복강경담총관탐사수술12례술중1차취진결석,4례중전개방수술1차취진결석,부2례결석무법일차취진,1개월후,용동양방법재차취석,전부취진.본조환자초성쇄석취석성공솔100%,수술시간90～240min,평균165min.주원시간5～10천,평균7.5천,술중출혈량50～100 ml.술후미발생감염、출혈혹담루등병발증.24례환자균재술후2～12개월래원복사,B초검사제시보담수술환자적담낭수축공능량호,담낭벽무수종,간내외담관미견결석복발.결론 흡당선택초성탐침여경피신경/수뇨관경탑배,EMS제삼대초성파탄도쇄석청석계통여복강경연합응용치료담석증,능취득비교호적효과,이차조작간단、술중출혈량소、수술시간교단、병인통고소、술후불량반응소.
Objective To study the feasibility and effect of the third generation of EMS lithoclast and ultrasound system to cure laparoscope. Methods To analyze 24 cases of clinical data of the third generation of lithoclast and ultrasound system in combination with percutaneous nephroscope and ureteroscope cured cholelithiasis. Results 6 cases of patient were successfully calculus removed for the first time. 12 cases of patients with laparoscopic choledochotomy were calculus removed for the first time, 4 cases of patients were calculus removed for open relay, and only 2 cases of patient; couldn't calculus removed for the first time,and calculus removed in the same way after one month. Operation success rate were 100% for all the patients,the operation time were 90-240 min, and on average 165 min. Length of stay were 5-10 days, on average 7.5 days and the amount of bleeding 50-100 ml. There weren't occurrence of infection, hemorrhage or bile leakage and other complications. 24 cases of patients were rechecked after 2-12 months, and after type-B ultrasonic check, we found the better gallbladder contraction function, without edematous of gallbladder and bile ducts inside and outside liver not relapse. Conclusions Fitting choosing ultrasound probe in combination with percutaneous nephroscope and ureteroscope, the third generation of EMS lithoclast and ultrasound system in combination with laparoscope, there were more effective and easy operative, the amount of bleeding, the shorter operation time, the smaller patient pain and untoward effect of postoperation.