中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
32期
37-37,39
,共2页
选择性肝血流控制%解剖性肝叶切除%肝内胆管结石%出血量%并发症
選擇性肝血流控製%解剖性肝葉切除%肝內膽管結石%齣血量%併髮癥
선택성간혈류공제%해부성간협절제%간내담관결석%출혈량%병발증
Selective hepatic blood flow control%Anatomic lobectomy%Intrahepatic bile duct stones%Bleeding%Complications
目的：研究分析在肝内胆管结石治疗中采用选择性肝血流控制下的解剖性肝叶切除方案的效果，为临床研究提供有效的理论依据。方法：2008年1月-2013年12月收治单侧肝胆管结石患者166例，其中左肝结石84例，右肝结石36例，全肝结石46例，合并胆总管结石患者56例，合并胆管狭窄30例，合并左肝内胆管癌4例。针对患者的不同症状情况采用针对性治疗。结果：术后发生并发症症状20例(12%)，死亡2例(1.2%)。142例治疗后无残留结石，10例有残留结石，10例中途放弃治疗并失去随访，4例经1年后再次治疗获得成功治愈。随访中，除放弃治疗患者外，未见任何复发病例。结论：将选择性肝血流控制下的解剖性肝叶切除手术应用于单侧肝内胆管结石的治疗中可有效减少患者手术治疗过程中的出血量和术后并发症情况，值得临床重视和推广。
目的：研究分析在肝內膽管結石治療中採用選擇性肝血流控製下的解剖性肝葉切除方案的效果，為臨床研究提供有效的理論依據。方法：2008年1月-2013年12月收治單側肝膽管結石患者166例，其中左肝結石84例，右肝結石36例，全肝結石46例，閤併膽總管結石患者56例，閤併膽管狹窄30例，閤併左肝內膽管癌4例。針對患者的不同癥狀情況採用針對性治療。結果：術後髮生併髮癥癥狀20例(12%)，死亡2例(1.2%)。142例治療後無殘留結石，10例有殘留結石，10例中途放棄治療併失去隨訪，4例經1年後再次治療穫得成功治愈。隨訪中，除放棄治療患者外，未見任何複髮病例。結論：將選擇性肝血流控製下的解剖性肝葉切除手術應用于單側肝內膽管結石的治療中可有效減少患者手術治療過程中的齣血量和術後併髮癥情況，值得臨床重視和推廣。
목적：연구분석재간내담관결석치료중채용선택성간혈류공제하적해부성간협절제방안적효과，위림상연구제공유효적이론의거。방법：2008년1월-2013년12월수치단측간담관결석환자166례，기중좌간결석84례，우간결석36례，전간결석46례，합병담총관결석환자56례，합병담관협착30례，합병좌간내담관암4례。침대환자적불동증상정황채용침대성치료。결과：술후발생병발증증상20례(12%)，사망2례(1.2%)。142례치료후무잔류결석，10례유잔류결석，10례중도방기치료병실거수방，4례경1년후재차치료획득성공치유。수방중，제방기치료환자외，미견임하복발병례。결론：장선택성간혈류공제하적해부성간협절제수술응용우단측간내담관결석적치료중가유효감소환자수술치료과정중적출혈량화술후병발증정황，치득림상중시화추엄。
Objective:To research and analyze the effect of the anatomical hepatectomy under the selective hepatic vascular control in the treatment of intrahepatic bile duct stones,to provide an effective theoretical basis for clinical studies.Methods:166 patients with unilateral bile duct stones were selected from January 2008 to December 2013.84 cases were left liver stones;36 cases were right liver stones;46 cases were whole liver stones;56 cases were biliary calculi;30 cases were merge bile duct stricture;4 cases were merge left intrahepatic cholangiocarcinoma.According to the different symptoms in patients with the use of targeted therapy.Results:After surgery,20 cases(12%)with symptoms of complications;2 cases(1.2%)died.After treatment,142 cases had no residual stones;10 cases had residual stones;10 cases dropped out treatment and lost follow-up;4 cases by 1 year had a successful cure after treatment again.During follow-up,in addition to abandon the treatment of patients,it did not show any recurrence. Conclusion:The anatomical hepatectomy under the selective hepatic vascular control in the treatment of intrahepatic bile duct stones can effectively reduce the amount of bleeding during surgery treatment and postoperative complications.It is worth to attention and promotion.
