溶石剂辅助内镜治疗胆管结石

目的 探讨内镜联合药物灌注溶石治疗复杂胆管结石的临床价值,提高对巨大胆管结石的治愈率。方法 38例均为肝胆管结石患先行内镜取石治疗结石未取净,分别经“T”管或经内镜鼻胆管引流（ENBD）等不同途径,并针对结石的类型不同,分别采用三种溶石剂经引流管灌注溶石,溶石前后行直接造影对比判断溶石效果。未完全溶解,再追加内镜或手术治疗;同时观察患溶石过程中的反应及有关血清生化指标变化。结果 38例患经内镜联合灌注溶石治疗后,溶石治愈率达63．16％（24／38）,溶石有效率达94．74％（36／38）,总治愈率达94．74％（36／38）,治疗效果显,溶石过程中无明显反应,生化指标无显性差异。结论 内镜联合灌注溶石治疗胆管结石是一种治疗胆石病的安全有效的方法。

Local Infusion of Dissolving Agents Assist in Therapeutic Endoscopy for Treatment of Cholelithiasis

Objective To explore the clinical value of endoscopy combined with local infusion of dissolving agents for treatment of cholelithiasis. Methods Thirty-eight patients with cholelithiasis were performed infusion with three kinds of dissolving agents according to the different types of the cholelith and the different infusion channel with "T" tube or endoscopic nasobiliary drainage(ENBD) tubes. The effect of treatment were judged by performing direct radiography before and after infusion. In patients whose gallstones were not been completely eliminated by dissolving agents, endoscopy or operation was performed again. During dissolving of gallstones, the reaction of patients and the variation of their serum biological-chemical indexes were observed. Results It was showed in these patients after local infusion of dissolving agents the cure rate for the cholelithiasis was 63.16%(24/38), the effective rate was 94.74%(36/38). The total cure rate of infusion dissvlving agents combined with endoscopy was 94.74%(36/38). The therapeutic efficacy was outstanding. The reaction of the patients is negligible in the course of dissolving gallstones. Significant difference was not found in serum biological-chemical indexes. Conclusion The endoscopy combined with local infusion of dissolving agents for treatment of cholelithiasis is safe and effective.