本文關(guān)鍵詞： 膽結(jié)石 膽管 肝內(nèi) 肝切除術(shù)/方法　出處：《中國(guó)普通外科雜志》2017年08期 　論文類(lèi)型：期刊論文

【摘要】：目的:探討基于區(qū)段肝蒂的肝切除術(shù)治療肝膽管結(jié)石的手術(shù)效果。方法:采用前瞻性病例對(duì)照研究,將90例肝膽管結(jié)石患者隨機(jī)分為研究組和對(duì)照組,每組各45例,研究組行基于區(qū)段肝蒂的肝切除術(shù),對(duì)照組采用B超定位的基于Couinaud肝葉段劃分方法的肝切除術(shù),比較兩組患者的相關(guān)臨床指標(biāo)。結(jié)果:兩組患者的一般情況、術(shù)前肝功能、結(jié)石分布、膽管變異和切肝范圍均無(wú)統(tǒng)計(jì)學(xué)差異(均P0.05)。研究組較對(duì)照組的術(shù)中出血量、術(shù)后并發(fā)癥發(fā)生率、引流量及術(shù)后結(jié)石殘留率均明顯降低(均P0.05),手術(shù)時(shí)間、輸血率、術(shù)后肝功能改變、術(shù)后排氣時(shí)間、術(shù)后住院時(shí)間兩組間比較無(wú)統(tǒng)計(jì)學(xué)差異(均P0.05)。結(jié)論:基于區(qū)段肝蒂的肝切除術(shù)具有出血量少,術(shù)后滲出及并發(fā)癥少、結(jié)石殘留率低等優(yōu)點(diǎn),適合在肝膽管結(jié)石肝切除手術(shù)中應(yīng)用。
[Abstract]:Objective: to investigate the effect of hepatectomy based on segmental liver pedicle on hepatolithiasis. Methods: 90 patients with hepatolithiasis were randomly divided into study group and control group with 45 cases in each group. The study group received hepatectomy based on segmental liver pedicle, while the control group underwent hepatectomy based on Couinaud segmental segmenting method. Results: the general condition of the two groups, preoperative liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function and liver function were compared between the two groups. There was no significant difference in the distribution of stones, the variation of bile duct and the scope of hepatectomy (all P 0.05). Compared with the control group, the amount of intraoperative bleeding, the incidence of postoperative complications, the drainage flow rate and the residual rate of postoperative stones in the study group were significantly lower than those in the control group (all P 0.05, operation time, blood transfusion rate). There was no significant difference in postoperative liver function change, postoperative exhaust time and postoperative hospitalization time between the two groups (P0.050.Conclusion: the hepatectomy based on segmental liver pedicle has the advantages of less bleeding, less postoperative exudation and complications, low residual stone rate, etc. It is suitable for hepatectomy for hepatolithiasis.
【作者單位】： 中山大學(xué)附屬佛山醫(yī)院膽道外科;
【基金】：廣東省佛山市醫(yī)學(xué)類(lèi)科技攻關(guān)基金資助項(xiàng)目(2014AB00266)
【分類(lèi)號(hào)】：R657.42

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