中国基层医药
中國基層醫藥
중국기층의약
Chinese Journal of Primary Medicine and Pharmacy
2015年
22期
3430-3432
,共3页
多肝段切除术%胆道镜取石术%复杂型肝内胆管结石%术后并发症
多肝段切除術%膽道鏡取石術%複雜型肝內膽管結石%術後併髮癥
다간단절제술%담도경취석술%복잡형간내담관결석%술후병발증
Multiple segmental resection%Choledochoscope lithotomy%Complex intrahepatic biliary calculi%Postoperative complication
目的：了解多肝段切除术联合胆道镜取石术在复杂型肝内胆管结石治疗中的作用，为该病提供有效的手术治疗方法。方法采用数字表法将213例复杂型肝内胆管结石被随机分为观察组117例和对照组96例，对照组采用多肝段切除术进行治疗，观察组采用多肝段切除术联合胆道镜取石术进行治疗。观察两组术后出现的并发症情况；术后对两组进行随访，并评价手术治疗效果。结果观察组住院时间（10．1±3．4）d，显著短于对照组的（13．7±4．6）d（t ＝6．560，P ＜0．05）。术后3～6周观察组结石残留率7．69％（9／117），低于对照组，差异有统计学意义（χ2＝4．099，P ＜0．05）。两组术后随访时间（11．2±3．9）个月。观察组手术优良率89．74％（105／117），高于对照组（χ2＝9．154，P ＜0．05）。观察组术后并发症发生率18．80％（22／117）低于对照组，差异有统计学意义（χ2＝14．467，P ＜0．05）。结论在复杂型肝内胆管结石的治疗中，多肝段切除术联合胆道镜取石术具有更好的疗效，术后并发症发生率较低，具有较高的临床应用价值。
目的：瞭解多肝段切除術聯閤膽道鏡取石術在複雜型肝內膽管結石治療中的作用，為該病提供有效的手術治療方法。方法採用數字錶法將213例複雜型肝內膽管結石被隨機分為觀察組117例和對照組96例，對照組採用多肝段切除術進行治療，觀察組採用多肝段切除術聯閤膽道鏡取石術進行治療。觀察兩組術後齣現的併髮癥情況；術後對兩組進行隨訪，併評價手術治療效果。結果觀察組住院時間（10．1±3．4）d，顯著短于對照組的（13．7±4．6）d（t ＝6．560，P ＜0．05）。術後3～6週觀察組結石殘留率7．69％（9／117），低于對照組，差異有統計學意義（χ2＝4．099，P ＜0．05）。兩組術後隨訪時間（11．2±3．9）箇月。觀察組手術優良率89．74％（105／117），高于對照組（χ2＝9．154，P ＜0．05）。觀察組術後併髮癥髮生率18．80％（22／117）低于對照組，差異有統計學意義（χ2＝14．467，P ＜0．05）。結論在複雜型肝內膽管結石的治療中，多肝段切除術聯閤膽道鏡取石術具有更好的療效，術後併髮癥髮生率較低，具有較高的臨床應用價值。
목적：료해다간단절제술연합담도경취석술재복잡형간내담관결석치료중적작용，위해병제공유효적수술치료방법。방법채용수자표법장213례복잡형간내담관결석피수궤분위관찰조117례화대조조96례，대조조채용다간단절제술진행치료，관찰조채용다간단절제술연합담도경취석술진행치료。관찰량조술후출현적병발증정황；술후대량조진행수방，병평개수술치료효과。결과관찰조주원시간（10．1±3．4）d，현저단우대조조적（13．7±4．6）d（t ＝6．560，P ＜0．05）。술후3～6주관찰조결석잔류솔7．69％（9／117），저우대조조，차이유통계학의의（χ2＝4．099，P ＜0．05）。량조술후수방시간（11．2±3．9）개월。관찰조수술우량솔89．74％（105／117），고우대조조（χ2＝9．154，P ＜0．05）。관찰조술후병발증발생솔18．80％（22／117）저우대조조，차이유통계학의의（χ2＝14．467，P ＜0．05）。결론재복잡형간내담관결석적치료중，다간단절제술연합담도경취석술구유경호적료효，술후병발증발생솔교저，구유교고적림상응용개치。
Objective To learn therapeutic effect of the combined treatment of multiple segmental resection and choledochoscope lithotomy on complex intrahepatic biliary calculi.To provide effective and reliable operation method for the treatment of disease.Methods 213 cases with complex intrahepatic biliary were randomly divided into observation group(117 cases)and control group(96 cases)by random number table method.The control group was treated with multiple segmental resection,the observation group was treated with multiple segmental resection com-bined choledochoscope lithotomy.The postoperative complications of the two groups were observed,and the patients of the two groups were followed up,and the effect of surgical treatment was evaluated.Results The hospitalization time of the observation group was (10.1 ±3.4)d,which was significantly shorter than (13.7 ±4.6)d of the control group (t =6.560,P <0.05).Postoperative 3 -6 weeks residual stone rate of the observation group was 7.69%(9 /117), which was lower than that of the control group,the difference was statistically significant (χ2 =4.099,P <0.05).In both two groups,the average duration of follow -up was (11.2 ±3.9)months.In the observation group,the excellent and good rate of surgery 89.74%(105 /117)was higher than the control group (χ2 =9.154,P <0.05).The postop-erative complication rate of the observation group 18.80%(22 /117)was lower than that of the control group,the difference was statistically significant (χ2 =14.467,P <0.05).Conclusion In the treatment of complex intrahepat-ic biliary calculi,the combined treatment of multiple segmental resection and choledochoscope lithotomy has better curative effect and low postoperative complication rate,with good clinical application value.
