| 摘要: |
| 目的 探讨经内镜逆行胰胆管造影联合腹腔镜术治疗胆总管结石伴胆囊结石患者,评估其手术效果及安全性,并检测血总胆红素、尿胰蛋白酶原-2及CRP水平。方法 选择本院2016年10月～2017年2月胆总管结石伴胆囊结石患者138例,随机将所有患者分为对照组(69例)和研究组(69例),对照组患者采用开腹胆囊切除术进行治疗,研究组患者经内镜逆行胰胆管造影联合腹腔镜手术进行治疗。主要观察两组患者手术状况、临床疗效及术后不良反应,并检测术后TBIL、尿胰蛋白酶原-2和CRP水平。结果 研究组切口大小、术中出血量、手术时间、术后排气时间和住院时间分别为(2.86±0.79)cm、(42.33±9.86)ml、(71.73±10.24)min、(18.93±2.54)h和(9.47±1.65)d,均低于对照组(6.92±1.03)cm、(75.21±10.17)ml、(98.46±11.58)min、(27.61±2.85)h和(14.39±2.07)d,差异具有统计学意义(P＜0.05)。研究组患者术后应用镇痛剂、术后并发症及残余结石发生率分别为13.04%(9/69)和2.90%(2/69),低于对照组63.77%(44/69)和10.14%(7/69),差异具有统计学意义(P＜0.05)。研究组术后TBIL、尿胰蛋白酶原-2和CRP分别为(62.40±18.37)μmol/L、(30.61±6.44)ng/ml和(247.39±26.15)mg/L,低于对照组(74.56±16.28)μmol/L、(41.98±7.35)ng/ml和(316.74±29.61)mg/L,差异具有统计学意义(P＜0.05)。结论 经内镜逆行胰胆管造影联合腹腔镜术治疗胆总管结石伴胆囊结石患者能够有效清除结石,具有创伤较小、并发症较少、术后恢复快等优点,值得临床推广应用。 |
| 关键词: 经内镜逆行胰胆管造影 腹腔镜术 胆总管结石伴胆囊结石 临床疗效 血总胆红素 尿胰蛋白酶原-2 CRP |
| DOI： |
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| The Clinical study of endoscopic retrograde cholangiopancreatography combined with laparoscopy for the treatment of common bile duct stones with gallstones |
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何锋
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The people's Hospital of Jiuquan city in Gansu Province
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| Abstract: |
| Objective To explore the operation efficacy and safety of endoscopic retrograde cholangiopancreatography combined with laparoscopic treat for common bile duct stones with gallstones, and to detect the serum bilirubin, urinary trypsinogen-2 and CRP levels.Methods 138 patients with common bile duct stones with gallstones were selected from October in 2016 to February in 2017 ,and they were randomly divided into control group (69 cases) and study group (69 cases). The patients in the control group were treated by open cholecystectomy.The patients of study group treated by endoscopic retrograde cholangiopancreatography combined with laparoscopic surgery.Mainly observed the two groups of patients with surgical conditions, clinical efficacy and postoperative adverse reactions, and detection of postoperative TBIL, urinary trypsinogen-2 and CRP levels.Results The average intraoperative blood loss incision size, intraoperative blood loss, operation time, postoperative exhaust time and hospital stay time of study group were (2.86±0.79)cm, (42.33±9.86) ml, (71.73±10.24) min, (18.93±2.54) h and (9.47±1.65) d, which were lower than those of the control group (6.92±1.03) cm (75.21±10.17) ml, (98.46 ± 11.58) min, (27.61±2.85) h and (14.39±2.07) d, the difference was statistically significant (P<0.05). The rate of analgesics, postoperative complications and residual stones of the study group were 13.04% (9/69) and 2.90% (2/69) respectively, which were lower than those of the control group (63.77% (44/69) and 10.14% 7/69), the difference was statistically significant (P <0.05). The levels of TBIL, urinary trypsinogen-2 and CRP were (62.40 ± 18.37) μmol/L, (30.61±6.44) ng/ml and (247.39±26.15) mg/L respectively, which were lower than those of the control group (74.56±16.28) μmol/L, (36.98±7.35) ng/ml and (316.74±29.61) mg/L, the difference was statistically significant (P <0.05). Conclusion Endoscopic retrograde cholangiopancreatography combined with laparoscopic treatment of common bile duct stones with gallstones can effectively remove stones, and it has advantages with less trauma, fewer complications, faster recovery.It is worthy of clinical application. |
| Key words: Endoscopic retrograde cholangiopancreatography Laparoscopic surgery Choledocholithiasis with gallstones Clinical efficacy Total bilirubin Urinary trypsinogen-2 CRP |
