中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2013年
4期
278-281
,共4页
刁红亮%乌尔班%罗超英%王金龙%刘光英%徐丽萍
刁紅亮%烏爾班%囉超英%王金龍%劉光英%徐麗萍
조홍량%오이반%라초영%왕금룡%류광영%서려평
肝包虫病%胆瘘%胆道镜%鼻胆管引流%治疗
肝包蟲病%膽瘺%膽道鏡%鼻膽管引流%治療
간포충병%담루%담도경%비담관인류%치료
Hepatic hydatid%Biliary fistula%Choledochoscope%Nasal bile duct drainage%Treatment
目的 评价胆道镜和鼻胆管引流治疗复杂肝包虫病合并胆瘘的应用价值.方法 回顾性总结分析复杂肝包虫合并胆瘘144例的临床资料.其中肝包虫内囊摘除+术中胆道镜探查和鼻胆管引流术组68例(治疗组),传统的内囊摘除术组76例(对照组),比较两组术式平均住院天数、残腔引流置管时间及残腔胆漏、残腔感染等指标.结果 两组比较,治疗组T管使用率、残腔感染、术后胆瘘发生率明显低于对照组;住院时间、带管出院率和平均带管天数明显小于对照组,差异均有统计学意义(P＜0.05).结论 复杂肝包虫手术中使用胆道镜检查和引导鼻胆管引流,可减少包虫内容物残留和胆瘘漏诊,能可靠地处理胆瘘,减轻胆道压力,部分胆漏患者可以一期缝合胆总管,术后胆瘘和残腔感染发生率低,技术难度低,值得推广.
目的 評價膽道鏡和鼻膽管引流治療複雜肝包蟲病閤併膽瘺的應用價值.方法 迴顧性總結分析複雜肝包蟲閤併膽瘺144例的臨床資料.其中肝包蟲內囊摘除+術中膽道鏡探查和鼻膽管引流術組68例(治療組),傳統的內囊摘除術組76例(對照組),比較兩組術式平均住院天數、殘腔引流置管時間及殘腔膽漏、殘腔感染等指標.結果 兩組比較,治療組T管使用率、殘腔感染、術後膽瘺髮生率明顯低于對照組;住院時間、帶管齣院率和平均帶管天數明顯小于對照組,差異均有統計學意義(P＜0.05).結論 複雜肝包蟲手術中使用膽道鏡檢查和引導鼻膽管引流,可減少包蟲內容物殘留和膽瘺漏診,能可靠地處理膽瘺,減輕膽道壓力,部分膽漏患者可以一期縫閤膽總管,術後膽瘺和殘腔感染髮生率低,技術難度低,值得推廣.
목적 평개담도경화비담관인류치료복잡간포충병합병담루적응용개치.방법 회고성총결분석복잡간포충합병담루144례적림상자료.기중간포충내낭적제+술중담도경탐사화비담관인류술조68례(치료조),전통적내낭적제술조76례(대조조),비교량조술식평균주원천수、잔강인류치관시간급잔강담루、잔강감염등지표.결과 량조비교,치료조T관사용솔、잔강감염、술후담루발생솔명현저우대조조;주원시간、대관출원솔화평균대관천수명현소우대조조,차이균유통계학의의(P＜0.05).결론 복잡간포충수술중사용담도경검사화인도비담관인류,가감소포충내용물잔류화담루루진,능가고지처리담루,감경담도압력,부분담루환자가이일기봉합담총관,술후담루화잔강감염발생솔저,기술난도저,치득추엄.
Objective To evaluate application value of choledochoscope and nasal bile duct drainage in the treatment of complicated liver echinococcosis combined biliary fistula.Methods The anthors retrospectively summarized and analyzed the clinical data of 144 patients with complicated liver echinococcosis combined biliary fistula.Treatment group (n 68) underwent liver hydatid internal capsule remove + intraoperative choledochoscopy and nose biliary drainage,control group (n-76) underwent the traditional internal capsule remove.The average length of hospital stay,residual cavity drainage catheter time,residual cavity bile leakage and residual cavity infection index of two groups were measured.Results The rate of T tube utilization,residual cavity infection,the incidence of biliary fistula in treatment group were significantly lower than the control group (P＜0.05).The length of hospital stay,the rate of discharge with drainage tube and the average length with tube were significantly less than control group (P＜0.05).Conclusion Intraoperative choledochoscopy and nasal bile duct drainage treatment of complicated liver hydatid,can reduce liver hydatid content residual and biliary fistula,reliable to deal with biliary fistula,part of a primary suture common bile duct,biliary fistula and residual cavity infection rate is low,patients recover quickly,shorter time of hospital stays,is worth popularizing.
