国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
1期
36-38
,共3页
王三贵%田晓%李挺山%张小玲%叶锡银%江志沅%刘衍民
王三貴%田曉%李挺山%張小玲%葉錫銀%江誌沅%劉衍民
왕삼귀%전효%리정산%장소령%협석은%강지원%류연민
胆囊结石病%外科手术%微创性%综合疗法%纤维胆道镜%保胆手术
膽囊結石病%外科手術%微創性%綜閤療法%纖維膽道鏡%保膽手術
담낭결석병%외과수술%미창성%종합요법%섬유담도경%보담수술
Cholecystolithiasis%Surgical procedures%minimally invasive%Combined modality therapy%Cholecystolithotomy%Gallbladder-preserving
目的 总结利用纤维胆道镜行微创保胆手术综合治疗胆囊结石的经验.方法 用内镜微创保胆取石手术及内镜微创保胆取石术后服用利胆护胆中药,对183例胆囊结石患者进行了随机对照分组,观察下列指标:术中:手术时间、术中出血量、胆瘘和胆总管损伤；术后:反流性胃炎食管炎、胆总管结石发病率、患者的消化功能、胆囊结石的复发率、胆囊壁的厚度、胆囊的收缩功能.结果 单纯内镜微创保胆取石组结石复发率为7.7％ (7/91),胆囊壁厚度为(3.5±0.6)mm,胆囊收缩功能为(34.0±3.6)％,内镜微创保胆取石加中药口服组结石复发率为1.1％(1/92),胆囊壁厚度为(2.5±0.5)mm,胆囊收缩功能为(48.0±4.5)％,上述两组对应值差异均有统计学意义(P＜0.01).结论 内镜微创保胆取石手术是一种安全有效的微创治疗方法,术后加用中药护胆治疗,能够降低保胆取石手术后胆囊结石复发率.
目的 總結利用纖維膽道鏡行微創保膽手術綜閤治療膽囊結石的經驗.方法 用內鏡微創保膽取石手術及內鏡微創保膽取石術後服用利膽護膽中藥,對183例膽囊結石患者進行瞭隨機對照分組,觀察下列指標:術中:手術時間、術中齣血量、膽瘺和膽總管損傷；術後:反流性胃炎食管炎、膽總管結石髮病率、患者的消化功能、膽囊結石的複髮率、膽囊壁的厚度、膽囊的收縮功能.結果 單純內鏡微創保膽取石組結石複髮率為7.7％ (7/91),膽囊壁厚度為(3.5±0.6)mm,膽囊收縮功能為(34.0±3.6)％,內鏡微創保膽取石加中藥口服組結石複髮率為1.1％(1/92),膽囊壁厚度為(2.5±0.5)mm,膽囊收縮功能為(48.0±4.5)％,上述兩組對應值差異均有統計學意義(P＜0.01).結論 內鏡微創保膽取石手術是一種安全有效的微創治療方法,術後加用中藥護膽治療,能夠降低保膽取石手術後膽囊結石複髮率.
목적 총결이용섬유담도경행미창보담수술종합치료담낭결석적경험.방법 용내경미창보담취석수술급내경미창보담취석술후복용리담호담중약,대183례담낭결석환자진행료수궤대조분조,관찰하렬지표:술중:수술시간、술중출혈량、담루화담총관손상；술후:반류성위염식관염、담총관결석발병솔、환자적소화공능、담낭결석적복발솔、담낭벽적후도、담낭적수축공능.결과 단순내경미창보담취석조결석복발솔위7.7％ (7/91),담낭벽후도위(3.5±0.6)mm,담낭수축공능위(34.0±3.6)％,내경미창보담취석가중약구복조결석복발솔위1.1％(1/92),담낭벽후도위(2.5±0.5)mm,담낭수축공능위(48.0±4.5)％,상술량조대응치차이균유통계학의의(P＜0.01).결론 내경미창보담취석수술시일충안전유효적미창치료방법,술후가용중약호담치료,능구강저보담취석수술후담낭결석복발솔.
Objective To investigate the effect of choledochoscopic gallbladder-preserving cholecystolithotomy combined with traditional Chinese medicine treatment.Methods A randomized controlled clinical study was conducted to analyze the 91 patients who were treated with choledochoscopic gallbladder-preserving cholecystolithotomy and 92 patients who underwent the same operation combined with subsequent treatment of traditional Chinese medicine.Intraoperative,postoperative and follow-up data were compared between the 2 groups (including operation time,blood loss,the rate of biliary fistula and common bile duct injury during the operation,gallbladder contraction function,the recurrence rate of gallstone,etc).Results In the simple choledochoscopic gallbladder-preserving cholecystolithotomy group,rate of gallstone recurrence was 7.7％ (7/91),the gallbladder wall was (3.5 ±0.6) mm,the gallbladder contraction function was (34.0 ± 3.6)％.However,the comprehensive treatment group,the rate of gallstone recurrence was 1.1％ (1/92),the gallbladder wall was(2.5 ±0.5) mm,the gallbladder contraction function was(48.0 ±4.5)％.There were significant differences between the two groups respectively (P ＜ 0.01,respectively).Conclusion Choledochoscopic gallbladder-preserving cholecystolithotomy combined with traditional Chinese medicine treatment is a safe,feasible,and minimal invasive approach for gallstone,and it can be considered as a alternative treatment of gallstone.
