中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
33期
110-111
,共2页
老年患者%肝外胆管结石%临床效果
老年患者%肝外膽管結石%臨床效果
노년환자%간외담관결석%림상효과
Elderly patients%Extrahepatic bile duct calculi%Clinical results
目的：探讨采用腹腔镜联合十二指肠镜治疗老年患者肝外胆管结石外科治疗的临床效果。方法：选取本院2011年3月-2013年1月收治的84例肝外胆管结石的老年患者作为研究对象，随机分为试验组和对照组各42例。试验组采用腹腔镜联合十二指肠镜进行治疗，对照组采用腹腔镜下胆囊切除、胆总管探查取石以及T管引流术进行治疗，观察两组患者的术后治疗效果。结果：试验组42例患者成功碎石、取石者38例，成功率90.48%，术后发生高淀粉酶血症1例，胰腺炎1例，穿刺孔出血1例，1例患者出现十二指肠乳头出血。对照组42例患者成功碎石、取石者31例，成功率73.81%，术后发高淀粉酶血症4例，胰腺炎2例，穿刺孔出血2例，3例患者出现十二指肠乳头出血。从患者术后治疗效果和并发症来看，试验组明显优于对照组，两组比较差异有统计学意义（P<0.05）。结论：应用腹腔镜联合十二指肠镜联合治疗老年肝外胆管结石优于单纯腹腔镜下胆总管探查+T管引流术，是目前较为安全和有效的方法，复发率低，临床应用价值高。
目的：探討採用腹腔鏡聯閤十二指腸鏡治療老年患者肝外膽管結石外科治療的臨床效果。方法：選取本院2011年3月-2013年1月收治的84例肝外膽管結石的老年患者作為研究對象，隨機分為試驗組和對照組各42例。試驗組採用腹腔鏡聯閤十二指腸鏡進行治療，對照組採用腹腔鏡下膽囊切除、膽總管探查取石以及T管引流術進行治療，觀察兩組患者的術後治療效果。結果：試驗組42例患者成功碎石、取石者38例，成功率90.48%，術後髮生高澱粉酶血癥1例，胰腺炎1例，穿刺孔齣血1例，1例患者齣現十二指腸乳頭齣血。對照組42例患者成功碎石、取石者31例，成功率73.81%，術後髮高澱粉酶血癥4例，胰腺炎2例，穿刺孔齣血2例，3例患者齣現十二指腸乳頭齣血。從患者術後治療效果和併髮癥來看，試驗組明顯優于對照組，兩組比較差異有統計學意義（P<0.05）。結論：應用腹腔鏡聯閤十二指腸鏡聯閤治療老年肝外膽管結石優于單純腹腔鏡下膽總管探查+T管引流術，是目前較為安全和有效的方法，複髮率低，臨床應用價值高。
목적：탐토채용복강경연합십이지장경치료노년환자간외담관결석외과치료적림상효과。방법：선취본원2011년3월-2013년1월수치적84례간외담관결석적노년환자작위연구대상，수궤분위시험조화대조조각42례。시험조채용복강경연합십이지장경진행치료，대조조채용복강경하담낭절제、담총관탐사취석이급T관인류술진행치료，관찰량조환자적술후치료효과。결과：시험조42례환자성공쇄석、취석자38례，성공솔90.48%，술후발생고정분매혈증1례，이선염1례，천자공출혈1례，1례환자출현십이지장유두출혈。대조조42례환자성공쇄석、취석자31례，성공솔73.81%，술후발고정분매혈증4례，이선염2례，천자공출혈2례，3례환자출현십이지장유두출혈。종환자술후치료효과화병발증래간，시험조명현우우대조조，량조비교차이유통계학의의（P<0.05）。결론：응용복강경연합십이지장경연합치료노년간외담관결석우우단순복강경하담총관탐사+T관인류술，시목전교위안전화유효적방법，복발솔저，림상응용개치고。
Objective: To investigate the clinical effect of extrahepatic bile duct surgery of elderly patients in treatment of laparoscopic combined with duodenoscopy.Method:Eighty-four elderly patients with extrahepatic bile duct stones were selected in the hospital from March 2011 to January 2013 as research subjects. All patients were randomly divided into the experimental group and the control group, each group of 42 cases. The experimental group patients were treated by laparoscopic combined with duodenoscopy therapy and the control group patients were treated by laparoscopic cholecystectomy times, common bile duct exploration and T tube drainage. Then clinical effects were compared after treatment.Result:The experimental group patients were successfully gravel, 38 cases were clean stone, the success rate was 90.48%.One case had hyperamylasemia, 1 case had pancreatitis, 1 case had bleeding puncture holes, 1 case had duodenal nipple bleeding. The control group patients were successfully gravel, 31 cases were clean stone, the success rate was 73.81%. Four cases had hyperamylasemia, 2 cases had pancreatitis, 2 cases had bleeding puncture holes, 3 cases had duodenal bleeding. Conclusion: Duodenoscopy combined with laparoscopic is better than laparoscopic common bile duct exploration + T tube drainage in treatment of senile extrahepatic bile duct stones what is a relatively safe and effective method with high value of clinical application.
