CAJ | 학술논문

目的：比较采用乳头括约肌小切开+气囊扩张术治疗及乳头括约肌切开术两种方法治疗胆总管结石的临床疗效。方法共收集2012年5月至2014年8月我院收治的236例胆总管结石患者，根据病例资料将患者按照所采用的不同治疗方法分为两组，观察组（采用EST+EPBD治疗）和对照组（采用EST治疗）各118例，比较两种治疗方法的胆管直径及结石数目、手术观察指标及并发症发生情况。结果观察组胆管直径及结石数目比较差异无统计学意义（P＞0.05）。观察组一次性成功率（85.59%）明显高于对照组（71.19%），机械碎石患者所占比例（14.41%）、并发症中出血发生率（1.69%）均明显低于对照组（36.44%、5.08%），操作时间及曝光时间均明显短于对照组，差异有统计学意义（P＜0.05）。结论胆总管结石患者采用乳头括约肌小切开联合气囊扩张术治疗疗效明显优于采用乳头括约肌切开术治疗，可明显提高一次性成功率、降低机械碎石及出血发生率，减少操作时间及曝光时间，可以在临床推广应用。
목적：비교채용유두괄약기소절개+기낭확장술치료급유두괄약기절개술량충방법치료담총관결석적림상료효。방법공수집2012년5월지2014년8월아원수치적236례담총관결석환자，근거병례자료장환자안조소채용적불동치료방법분위량조，관찰조（채용EST+EPBD치료）화대조조（채용EST치료）각118례，비교량충치료방법적담관직경급결석수목、수술관찰지표급병발증발생정황。결과관찰조담관직경급결석수목비교차이무통계학의의（P＞0.05）。관찰조일차성성공솔（85.59%）명현고우대조조（71.19%），궤계쇄석환자소점비례（14.41%）、병발증중출혈발생솔（1.69%）균명현저우대조조（36.44%、5.08%），조작시간급폭광시간균명현단우대조조，차이유통계학의의（P＜0.05）。결론담총관결석환자채용유두괄약기소절개연합기낭확장술치료료효명현우우채용유두괄약기절개술치료，가명현제고일차성성공솔、강저궤계쇄석급출혈발생솔，감소조작시간급폭광시간，가이재림상추엄응용。
Objective To compare the effect of sphincter small incision+balloon dilatation therapy and sphincterotomy clinical efifcacy of the two methods of common bile duct stones. Methods 236 cases of common bile duct stones in patients were collected from May 2012 to August 2014 in our hospital, according to clinical data of patients according to the different treatment methods used they were divided into two groups, the observation group(used EST+EPBD treatment)and the control group(used the EST treatment)had 118 cases, bile duct stones in diameter and the number of surgical complications observed indicators of the two treatments were compared. Results Bile duct diameter and number of stones in the observation group difference was not statistically signiifcant(P>0.05). A one-time success rate of the observation group(85.59%)was signiifcantly higher(71.19%), the proportion of mechanical lithotripsy patients(14.41%), the incidence of bleeding complications(1.69%)were signiifcantly lower than the control group (36.44%, 5.08%), the operating time and the exposure time was signiifcantly shorter than the control group, the difference was statistically signiifcant(P<0.05). Conclusion Choledocholith iasis small incision patients with papillary sphincter balloon dilatation combined therapy was superior to sphincterotomy treatment can signiifcantly improve the success rate of a one-time, reducing the incidence of mechanical lithotripsy and bleeding, reduce operating time and exposure time in clinical application.