联合应用硬直胆镜与纤维胆管镜治疗胆管术后残石的疗效分析

目的探讨联合应用硬直胆镜("李逊"镜)与纤维胆管镜共同治疗胆管术后残石的疗效。方法将广州市番禺区何贤纪念医院于2009年10月至2012年6月术后确诊的60例胆管残石患者随机分为联合应用硬直胆镜与纤维胆管镜取石组(观察组)和单纯纤维胆管镜取石组(对照组),各30例,观察两组患者的一次取石成功率,取石次数,最后残石率及并发症发生率。结果观察组一次取石成功率为86.6%,每例取石次数为1～3次,平均(1.5±0.1)次,最后残石率为3.3%,并发症发生率为3.3%,而对照组一次取石成功率为63.3%,每例取石1～5次,平均(2.8±0.2)次,最后残石率为6.6%,并发症发生率为6.6%,两组结果比较,观察组取石次数较对照组显著减少,一次取石成功率较高,最后残石率及并发症发生率显著降低(P<0.05)。结论联合应用硬直胆镜与纤维胆管镜比单纯应用纤维胆管镜取术后残石更有效,可使一次取石成功率增高。

The Curative Effect Analysis of the Rigid Choledochoscopy Combined with Fiber Choledochoscope in Treatment of Biliary Residual Stones

Objective To investigate the curative effect of rigid choledochoscopy(Lixun ureteroscopy) combined with fiber choledochoscope in treatment of biliary residual stones.Methods Sixty cases of postoperative residual biliary stones from Hexian's Memorial Hospital of Panyu Guangzhou from Oct.2010 to Jun.2012 were randomly divided into the combined application of two choledochoscopy group(observation group) and simply choledochofibersope group(control group),30 cases in each,and then the success rate of stone removal,stone extraction times,the residual stone rate and incidence of complications of the two groups were observed.Results Observation group: stone once-taking success rate was 86.6%,each patient stone taking number was 1-3 time,(1.5 ± 0.1) time on average,the last residual stone rate was 3.3%,the complication rate was 3.3%;the control group,stone once-taking success rate was 63.3%,each patient stone-taking number was about 1-5 time,(2.8 ± 0.2) time on average,the last residual stone rate reached 6.6%,the complication rate was 6.6%.The observation group stone-taking number was obviously less than that of the control group,and the once-takingsuccessful rate was higher,the residual stone rate and complication rate was lower in the observation group,with statistically significant difference(P < 0.05).Conclusion Combined application of rigid choledochoscope and fiber choledochoscope is more effective than fiber choledochoscope for postoperative residual stone-taking,which can make stone once taking success rate increased.