CAJ | 학술논문

目的：探讨硬质胆道镜治疗肝胆管结石的临床效果及其应用。方法：选择肝胆管结石患者78例，随机分为硬质胆道镜组（A 组）40例和纤维胆道镜组（B组）38例。A组患者行辅助硬质胆道镜碎石，对B组患者行辅助纤维胆道镜碎石，分析比较两组患者手术时间、术中出血量、术中输血量及即刻结石残留率、最终结石残留率和胆管炎复发率。结果：A组患者手术时间为127．8±78．7min ，术中输血量为108．8±86．2ml ，术中出血量为20．6±25．9ml ，明显低于B组（手术时间213．2±50．9min ，术中输血量195．7±205．7ml ，术中出血量256．1±155．8ml），两组相比有显著性差异（P＜0．05）。A组患者即刻结石残留率为2．6％，最终结石残留率为5．3％，胆管炎复发率为5．1％；B组患者即刻结石残留率为18．6％，最终结石残留率为23．8％，胆管炎复发率为23．8％。两组患者相比有显著性差异（ P＜0．05）。A组患者结石复发率为12．8％，B组患者结石复发率为23．8％，两组相比无显著性差异（ P＞0．05）。结论：硬质胆道镜治疗肝胆管结石安全、微创、有效，短期疗效优于辅助纤维胆道镜碎石组，远期疗效与纤维胆道镜相当。
목적：탐토경질담도경치료간담관결석적림상효과급기응용。방법：선택간담관결석환자78례，수궤분위경질담도경조（A 조）40례화섬유담도경조（B조）38례。A조환자행보조경질담도경쇄석，대B조환자행보조섬유담도경쇄석，분석비교량조환자수술시간、술중출혈량、술중수혈량급즉각결석잔류솔、최종결석잔류솔화담관염복발솔。결과：A조환자수술시간위127．8±78．7min ，술중수혈량위108．8±86．2ml ，술중출혈량위20．6±25．9ml ，명현저우B조（수술시간213．2±50．9min ，술중수혈량195．7±205．7ml ，술중출혈량256．1±155．8ml），량조상비유현저성차이（P＜0．05）。A조환자즉각결석잔류솔위2．6％，최종결석잔류솔위5．3％，담관염복발솔위5．1％；B조환자즉각결석잔류솔위18．6％，최종결석잔류솔위23．8％，담관염복발솔위23．8％。량조환자상비유현저성차이（ P＜0．05）。A조환자결석복발솔위12．8％，B조환자결석복발솔위23．8％，량조상비무현저성차이（ P＞0．05）。결론：경질담도경치료간담관결석안전、미창、유효，단기료효우우보조섬유담도경쇄석조，원기료효여섬유담도경상당。
Objective:To study the clinical effect of percutaneous liver puncture combined rigid choledo‐choscope for the treatment of hepatolith .Methods:Selected 78 cases of patients in our hospital for treatment and randomly divided into hard lens group (group A ,40 cases) and hepatic resection group (group B ,38 cases) .Group A received hard mirror ,while group B received hepatectomy .Compared two groups of patients with operation time ,intraoperative blood loss ,intraoperative blood transfusion ,immediate retention rate ,final stones residual rate and calculi recurrence rate .Results :The operation time of group A was 127 .8 ± 78 .7min ,amount of transfused was 108 .8 ± 86 .2 ml ,intraoperative blood loss was 20 .6 ± 25 .9ml ,while group B was 213 .2 ± 50 .9 min ,195 .7 ± 205 .7 ml ,256 .1 ± 155 .8 ml ,and the difference between the two groups was statistically significant (P <0 .05) .Group A immediate residual rate was 2 .6% ,final stones residual rate was 5 .3% ,recurrent cholangitis was 5 .1% ,while group B was 18 .6% ,23 .8% and 23 .8% ,and the difference between the two groups was statistically significant (P< 0 .05) .Stone recurrence rate of group A was 12 .8% ,while in group B was 23 .8% .The difference was no statisti‐cal significance (P>0 .05) .Conclusion:Hard mirror hepatolith is safe ,minimally invasive and effective ,the short‐term curative effect is better than that of liver resection group .And its long‐term curative effect is the same as the liver resection .