硬质胆道镜和纤维胆道镜在肝内胆管结石中的应用比较(1)
【摘要】 目的：探讨硬质胆道镜和纤维胆道镜在肝内胆管结石中的疗效。方法：选择2014年1月-2015年1月在本院接受治疗的肝内胆管结石患者180例作为研究对象，采用随机数字表法分为研究组和对照组，分别应用硬质胆道镜和纤维胆道镜进行取石治疗，记录比较两组手术时间、术中出血量、术中输血量、一次取石率、探查成功率、肝内胆管巨大嵌顿取石率、肝脏边缘结石取出率、残石率、并发症发生率、再手术率及胆道炎复发率。结果：研究组手术时间、术中出血量、术中输血量、一次取石率、探查成功率及肝内胆管巨大嵌顿取石率均优于对照组，研究组肝脏边缘结石取出率低于对照组，以上比较差异均有统计学意义(P<0.05)；再手术率及胆道炎复发率比较 两组残石率、并发症发生率、再手术率及胆道炎复发率比较，差异无统计学意义(P>0.05)。结论：硬质胆道镜和纤维胆道镜在治疗肝内胆管结石中各有优势，硬质胆道镜优势更为明显，临床可合理配合使用，提高取石成功率。
【关键词】 硬质胆道镜； 纤维胆道镜； 肝内胆管结石
, 百拇医药
【Abstract】 Objective：To investigate the curative effect of rigid choledochoscope and choledochofiberscope in intrahepatic biliary calculi.Method：180 patients who administered intrahepatic biliary calculi operation in our hospital from January 2014 to January 2015 were divided into the research group and the control group randomly.Rigid choledochoscope was applied to the research group and choledochofiberscope was applied to the control group.The operation time，intraoperative blood loss，intraoperative blood transfusion，once stone-free rate，exploration success rate，intrahepatic bile duct giant stone remove rate，liver edge stone eliminating rate，residual stone rate，complication rate，reoperation rate and recurrence rate of cholangitis were recorded and compared between the two groups.Result：The operation time，intraoperative blood loss，intraoperative blood transfusion，once stone-free rate，exploration success rate and intrahepatic bile duct giant stone remove rate of the research group were better than those of the control group.The liver edge stone eliminating rate of the research group was lower than that of the control group.The differences above were all statistically significant(P<0.05).The differences in the residual stone rate，complication rate，reoperation rate and cholangitis recurrence rate of the two groups were not statistically significant(P>0.05).Conclusion：Rigid choledochoscope and choledochofiberscope both have their own advantages in intrahepatic biliary calculi operation and the advantages of rigid choledochoscope are more obvious.They shall be used reasonably to improve the eliminating rate of biliary calculi.
, 百拇医药
【Key words】 Rigid choledochoscope； Choledochofiberscope； Intrahepatic biliary calculi
First-author’s address：The First People’s Hospital of Jingdezhen City，Jingdezhen 333000，China
doi：10.3969/j.issn.1674-4985.2015.31.019
结石症是临床多发病，其中以肝内胆管结石为主[1]。肝内胆管结石是指左右肝管汇合部以上各分支胆管内的结石[2]。临床不仅发病率高且残石率和再手术率均较高，在临床治疗中难度较大，同时结石可引起胆囊炎、急性梗阻性化脓性胆管炎，严重降低患者生活质量，甚至威胁患者生命[3]。现阶段治疗肝内胆管结石主要是清除结石病灶、解除梗阻、通畅引流[4]。传统的开腹手术取石并行肝规则切除创伤大、残石率高，且术后恢复慢、并发症多[5]。随着内镜和微创技术的快速发展，胆道镜在治疗肝内胆管上应用广泛，其中硬质胆道镜与纤维胆道镜是腹腔镜胆管探查中的主要工具[6]。本研究通过探讨硬质胆道镜与纤维胆道镜在肝内胆管结石中的优缺点，旨在为临床提高肝内胆管结石的取石率、降低并发症提供理论依据，现报道如下。, 百拇医药(赵俊 周毅 黄涛 张小斌)
【关键词】 硬质胆道镜； 纤维胆道镜； 肝内胆管结石
, 百拇医药
【Abstract】 Objective：To investigate the curative effect of rigid choledochoscope and choledochofiberscope in intrahepatic biliary calculi.Method：180 patients who administered intrahepatic biliary calculi operation in our hospital from January 2014 to January 2015 were divided into the research group and the control group randomly.Rigid choledochoscope was applied to the research group and choledochofiberscope was applied to the control group.The operation time，intraoperative blood loss，intraoperative blood transfusion，once stone-free rate，exploration success rate，intrahepatic bile duct giant stone remove rate，liver edge stone eliminating rate，residual stone rate，complication rate，reoperation rate and recurrence rate of cholangitis were recorded and compared between the two groups.Result：The operation time，intraoperative blood loss，intraoperative blood transfusion，once stone-free rate，exploration success rate and intrahepatic bile duct giant stone remove rate of the research group were better than those of the control group.The liver edge stone eliminating rate of the research group was lower than that of the control group.The differences above were all statistically significant(P<0.05).The differences in the residual stone rate，complication rate，reoperation rate and cholangitis recurrence rate of the two groups were not statistically significant(P>0.05).Conclusion：Rigid choledochoscope and choledochofiberscope both have their own advantages in intrahepatic biliary calculi operation and the advantages of rigid choledochoscope are more obvious.They shall be used reasonably to improve the eliminating rate of biliary calculi.
, 百拇医药
【Key words】 Rigid choledochoscope； Choledochofiberscope； Intrahepatic biliary calculi
First-author’s address：The First People’s Hospital of Jingdezhen City，Jingdezhen 333000，China
doi：10.3969/j.issn.1674-4985.2015.31.019
结石症是临床多发病，其中以肝内胆管结石为主[1]。肝内胆管结石是指左右肝管汇合部以上各分支胆管内的结石[2]。临床不仅发病率高且残石率和再手术率均较高，在临床治疗中难度较大，同时结石可引起胆囊炎、急性梗阻性化脓性胆管炎，严重降低患者生活质量，甚至威胁患者生命[3]。现阶段治疗肝内胆管结石主要是清除结石病灶、解除梗阻、通畅引流[4]。传统的开腹手术取石并行肝规则切除创伤大、残石率高，且术后恢复慢、并发症多[5]。随着内镜和微创技术的快速发展，胆道镜在治疗肝内胆管上应用广泛，其中硬质胆道镜与纤维胆道镜是腹腔镜胆管探查中的主要工具[6]。本研究通过探讨硬质胆道镜与纤维胆道镜在肝内胆管结石中的优缺点，旨在为临床提高肝内胆管结石的取石率、降低并发症提供理论依据，现报道如下。, 百拇医药(赵俊 周毅 黄涛 张小斌)