【摘要】：目的：探討經(jīng)皮肝穿刺膽道鏡取石術(shù)在肝內(nèi)膽管結(jié)石微創(chuàng)治療的可行性和臨床應(yīng)用價(jià)值,尤其在復(fù)雜性肝內(nèi)膽管結(jié)石治療中的優(yōu)勢(shì)。方法：回顧性分析45例肝內(nèi)膽管結(jié)石患者的臨床資料,(男性患者19例,女性患者26例,年齡20-84歲。分為實(shí)驗(yàn)組、對(duì)照組,實(shí)驗(yàn)組行經(jīng)皮肝穿刺膽道鏡取石術(shù),對(duì)照組行傳統(tǒng)手術(shù),主要以膽總管切開取石、T管引流術(shù)為主,必要時(shí)結(jié)合肝葉切除術(shù)、膽腸吻合術(shù)等。比較兩組術(shù)后殘余結(jié)石率、術(shù)后并發(fā)癥、術(shù)后1年結(jié)石復(fù)發(fā)率等。結(jié)果：最終共有43例病例可評(píng)價(jià),實(shí)驗(yàn)組有2例患者因穿刺失敗中轉(zhuǎn)開腹手術(shù)。①兩組在結(jié)石清除率,術(shù)后肝功能恢復(fù),術(shù)后1年結(jié)石復(fù)發(fā)率方面差異無統(tǒng)計(jì)學(xué)意義(P0.05)。②實(shí)驗(yàn)組在術(shù)中出血、手術(shù)時(shí)間、術(shù)后并發(fā)癥、術(shù)后胃腸功能恢復(fù)、手術(shù)切口、疼痛評(píng)分等方面優(yōu)于對(duì)照組(P0.05)。結(jié)論：經(jīng)皮肝穿刺膽道鏡取石術(shù)可達(dá)到微創(chuàng)治療肝內(nèi)膽管結(jié)石、保護(hù)肝功能的目的,本方法具有創(chuàng)傷小、并發(fā)癥少、取石率高、殘石率低、術(shù)后疼痛輕等優(yōu)點(diǎn)。
[Abstract]:Objective: to investigate the feasibility and clinical value of percutaneous transhepatic choledocholithotomy in the minimally invasive treatment of intrahepatic cholelithiasis, especially in the treatment of complicated intrahepatic cholelithiasis. Methods: the clinical data of 45 patients with intrahepatic cholelithiasis were retrospectively analyzed (19 male and 26 female, aged 20-84 years). The patients were divided into experimental group, control group, the experimental group underwent percutaneous transhepatic choledochoscopy, and the control group underwent traditional operation, mainly by choledocholithotomy, T-tube drainage, liver lobectomy and cholangiojejunostomy when necessary. The rate of residual stones, postoperative complications and recurrence rate of stone were compared between the two groups. Results: a total of 43 cases could be evaluated. In the experimental group, 2 cases were converted to open operation due to the failure of puncture. 1 in the two groups, the stone clearance rate and liver function were recovered after operation. There was no significant difference in the recurrence rate of calculi 1 year after operation (P0.05). 2 the experimental group was superior to the control group in the aspects of intraoperative bleeding, operation time, postoperative complications, postoperative gastrointestinal function recovery, surgical incision, pain score and so on (P0.05). Conclusion: percutaneous transhepatic choledochoscopic lithotomy can achieve the purpose of minimally invasive treatment of intrahepatic cholelithiasis and protection of liver function. This method has the advantages of less trauma, less complications, higher lithotomy rate, lower residual stone rate and less postoperative pain.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R657.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 韓新巍,李永東,高雪梅,馬波,吳剛,邢古生;經(jīng)皮肝穿刺膽道造影術(shù)下膽管活檢的臨床研究[J];介入放射學(xué)雜志;2002年05期

2 溫子龍;薛平;盧海武;鄭強(qiáng);;改良經(jīng)皮肝膽道鏡治療復(fù)雜肝內(nèi)外膽管結(jié)石[J];嶺南現(xiàn)代臨床外科;2011年03期

3 王平;方兆山;孫北望;謝嘉奮;劉衍民;葉琛;;經(jīng)皮肝膽道硬鏡碎石治療肝膽管結(jié)石手術(shù)路徑選擇的臨床研究[J];實(shí)用醫(yī)學(xué)雜志;2014年20期

4 劉衍民,曾可偉,王純忠,陸光生,文輝清;改良的經(jīng)皮經(jīng)肝膽道鏡術(shù)治療肝內(nèi)膽管結(jié)石(附15例報(bào)告)[J];外科理論與實(shí)踐;2004年06期

5 周任;官英勇;鄭惠光;彭民浩;;纖維膽道鏡在治療肝內(nèi)膽管結(jié)石中的應(yīng)用[J];中國內(nèi)鏡雜志;2008年05期

6 何振平,范林軍,鄭樹國,董家鴻,王曙光,別平,蔡景修,韓本立,李智華,馬寬生,陳平,劉永雄,黃志強(qiáng);肝切除治療肝膽管結(jié)石(附644例報(bào)告)[J];中華肝膽外科雜志;2000年03期

7 鐘先榮;譚志軍;孔勇;汪祖來;陳澤華;陳坤;;腹腔鏡聯(lián)合輸尿管鏡彈道碎石治療肝膽管結(jié)石36例分析[J];中國普外基礎(chǔ)與臨床雜志;2010年04期

8 韋楊年;黃海;莫世發(fā);王克凈;張洪昌;譚新華;李泉;;精準(zhǔn)肝切除在肝膽管結(jié)石病的臨床應(yīng)用[J];中國普外基礎(chǔ)與臨床雜志;2011年01期

9 王世杰;黃強(qiáng);謝放;;肝切除術(shù)治療肝內(nèi)膽管結(jié)石療效分析[J];中國普通外科雜志;2010年02期

10 金山;;肝內(nèi)膽管結(jié)石的病因及發(fā)病機(jī)制[J];世界華人消化雜志;2012年34期

，

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