中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
7期
514-516
,共3页
梁建深%叶有强%汤聪%吴一武%汤治平%候冰宗
樑建深%葉有彊%湯聰%吳一武%湯治平%候冰宗
량건심%협유강%탕총%오일무%탕치평%후빙종
胆结石%激光疗法%螺旋水刀
膽結石%激光療法%螺鏇水刀
담결석%격광요법%라선수도
Cholelithiasis%Laser therapy%Helix hydro-jet
目的 探讨螺旋水刀与钬激光碎石治疗肝内胆管结石的临床疗效和安全性.方法 158例肝内胆管结石患者随机分为螺旋水刀试验组(82例)和钬激光对照组(76例),观察碎石时间、碎石次数、残石率、术后结石复发率、术中出血、术中冲洗水量、术中镇痛、术后出血、术后发热等指标.结果 2组患者在碎石次数、残石率、术后结石复发率比较,差异无统计学意义(P＞0.05);水刀组和激光组在术中冲洗水量[(2300±275) ml比2 850±331)ml,P=0.002]、碎石时间(54.2±15.3) min比(38.1 ±12.7) min(x2=1.748,P=0.041)、术中出血(19例比29例,x2=4.189,P=0.041)、术中镇痛(2例比9例,x2=5.384,P=0.032)、术后出血(11例比21例,x2=4.936,P=0.037)、术后发热等并发症(30例比62例P =0.027),2组指标比较,差异有统计学意义(P＜0.05).结论 螺旋水刀与钬激光碎石治疗肝内胆管结石都是安全、有效的方法,钬激光碎石效率更高,螺旋水刀碎石更安全.
目的 探討螺鏇水刀與鈥激光碎石治療肝內膽管結石的臨床療效和安全性.方法 158例肝內膽管結石患者隨機分為螺鏇水刀試驗組(82例)和鈥激光對照組(76例),觀察碎石時間、碎石次數、殘石率、術後結石複髮率、術中齣血、術中遲洗水量、術中鎮痛、術後齣血、術後髮熱等指標.結果 2組患者在碎石次數、殘石率、術後結石複髮率比較,差異無統計學意義(P＞0.05);水刀組和激光組在術中遲洗水量[(2300±275) ml比2 850±331)ml,P=0.002]、碎石時間(54.2±15.3) min比(38.1 ±12.7) min(x2=1.748,P=0.041)、術中齣血(19例比29例,x2=4.189,P=0.041)、術中鎮痛(2例比9例,x2=5.384,P=0.032)、術後齣血(11例比21例,x2=4.936,P=0.037)、術後髮熱等併髮癥(30例比62例P =0.027),2組指標比較,差異有統計學意義(P＜0.05).結論 螺鏇水刀與鈥激光碎石治療肝內膽管結石都是安全、有效的方法,鈥激光碎石效率更高,螺鏇水刀碎石更安全.
목적 탐토라선수도여화격광쇄석치료간내담관결석적림상료효화안전성.방법 158례간내담관결석환자수궤분위라선수도시험조(82례)화화격광대조조(76례),관찰쇄석시간、쇄석차수、잔석솔、술후결석복발솔、술중출혈、술중충세수량、술중진통、술후출혈、술후발열등지표.결과 2조환자재쇄석차수、잔석솔、술후결석복발솔비교,차이무통계학의의(P＞0.05);수도조화격광조재술중충세수량[(2300±275) ml비2 850±331)ml,P=0.002]、쇄석시간(54.2±15.3) min비(38.1 ±12.7) min(x2=1.748,P=0.041)、술중출혈(19례비29례,x2=4.189,P=0.041)、술중진통(2례비9례,x2=5.384,P=0.032)、술후출혈(11례비21례,x2=4.936,P=0.037)、술후발열등병발증(30례비62례P =0.027),2조지표비교,차이유통계학의의(P＜0.05).결론 라선수도여화격광쇄석치료간내담관결석도시안전、유효적방법,화격광쇄석효솔경고,라선수도쇄석경안전.
Objective To evaluate the curative effect,safety,advantages and disadvantages of helix hydro-jet and holmium laser lithotripsy in the treatment of intrahepatic bile duct stones.Methods 158 patients of intrahepatic bile duct stones were divided into helix hydro-jet group (n =82) and helix hydro-jet group (n =76).Time of lithotripsy,frequencies of lithotripsy,residual stone,intraoperative hemorrhage,postoperative hemorrhage,stone recurrence rate,postoperative fever,and therapeutic efficacy were compared between the two groups.Results There was no significant difference between the two groups on frequency of lithotripsy,residual stone rate and stone recurrence rate (P ＞ 0.05) ; whereas intraoperative washing normal saline (2 300 ± 275) ml vs (2 850 ± 331) ml,(P =0.002),the time of lithotripsy (54.2 ± 15.3) min vs (38.1 ± 12.7) min,P =0.041,intraoperative hemorrhage (19 cases vs 29 cases,P =0.041),Intraoperative analgesia (2 cases vs 9 cases,P =0.032),postoperative hemorrhage (11 cases vs 21 cases,P =0.037),and postoperative fever (30 cases vs 62 cases,P =0.027) had significant differences(P ＜ 0.05).Conclusions Both helix hydro-jet and the holmium laser lithotripsy is safe and effective for the treatment of intrahepatic bile duct stones.Holmium laser is more efficient than Helix Hydro-jet,while helix hydro-jet is safer than holmium laser in lithotripsy.
