摘要
【目的】探讨经皮肝胆管穿刺碎石取石术（PTCSL）治疗复杂肝胆管结石的临床疗效。【方法】选择2014年2月至2016年12月本科室收治的120例复杂性肝胆管结石患者的临床资料，根据其手术方式的不同将其分为PTCSL组和常规治疗组，每组各60例。记录两组患者结石取净例数、术中出血量、术后住院时间及并发症发生情况。【结果】PTCSL组结石取净率为80．OO％显著高于常规治疗组的31．67％，差异有统计学意义（P〈0．05）。PTCSL组术中出血量明显低于常规治疗组，术后住院时间明显短于常规治疗组，两组比较差异有统计学意义（P〈0．05）。PTCSL组患者术后胆漏、肝脓肿、胆道出血、伤口感染发生率显著低于常规治疗组，差异有统计学意义（P〈O．05）。【结论】PTCSL治疗复杂肝胆管结石具有安全可靠，结石取净率高、出血量少、并发症少、住院时间短等优点，值得临床推广使用。
[Objective]To analyze clinical therapeutic effects of percutaneous transhepatic cholangioscopic lithotomy （PTCSL） in the treatment of hepatolithiasis.[Methods]lA total of 120 cases of patients with compli- cated hepatic bile duct stones treated in our hospital from February 2014 to December 2016 were selected as the research objects. Sixty cases were treated with PTCSL, while another sixty cases were treated with conven- tional treatment. The observation group （group PTCSL） was treated with percutaneous transhepatic cholan- gioscopic lithotomy （PTCSL） with Holmium laser. The routine group was treated with traditional open sur- gery The calculi removal rate, intraoperative blood loss and postoperative complications Of the two groups were statistically analyzed.[Results]In the group PTCSL, the calculi removal rate was 80.0%.In the routine group, the calculi removal rate was 31.67%, which was lower than that of group PTCSL; the difference be- tween the two groups was statistically significant （ P （0.05）.The mean bleeding volume of group PTCSL （ 18.31 ± 10.12） mL was significantly lower than that of the routine group （317.76 ± 41.30） mL there was sig- nificant difference between two groups （P 〈 0.05）. The incidence of postoperative complications in group PTCSL was 15.23%, lower than that of the routine group, which was was 40.67% the difference was signifi- cant （ P （0.05）. In group PTCSL, the postoperative hospital stay was shorter than the routine group there was significant difference between two groups （ P 〈0.05）.[Conclusions]Percutaneous transhepatic cholangio- scopic lithotomy （PTCSL）is a safe and reliable method for the treatment of complicated hepatolithiasis. It has the advantages of high stone removal rate, less bleeding, fewer complications, shorter postoperative hospital stay, and is suitable for clinical use.
作者
马璞玉
蒋超
陈晨
崔鹏
翁曦
汪新天
MA Pu-yu JIANG Chao CHEN Chen et al(Department of Hepatobiliary Surgery, the First Affiliated Hospital of Hunan Normal University, Changsha , Hunan ,410005, China)
出处
《医学临床研究》
CAS
2017年第9期1665-1667,共3页
Journal of Clinical Research
基金
国家自然科学基金面上项目（81372157）
湖南省自然科学基金面上项目（2017JJ2152）
湖南省卫生厅科研基金课题（B2011-082）
湖南省长沙市科技局项目（K1307041-31）
湖南省长沙市财政局项目（长沙企指[2014]123）
关键词
穿刺术
碎石术
胆管
肝内
胆结石/外科学
治疗结果
Punctures
Lithotripsy
Bile Ducts, Intrahepatic
Cholelithiasis/SU
TreatmentOutcome
