手术治疗肝内胆管结石并胆管狭窄的效果分析

目的：评价手术治疗肝内胆管结石并胆管狭窄的临床效果。方法选取2011年3月∽2013年12月本院收治的肝内胆管结石并胆管狭窄患者128例，随机分为两组，各64例，对照组根据病情的不同，选择相应的手术方式；观察组在对照组的基础上进行术中胆道镜探查及取石处理。观察并比较两组的临床疗效、并发症发生率及复发情况。结果观察组的优良率为96.9%，明显高于对照组的84.4%，差异有统计学意义（P〈0.05）；观察组的并发症发生率低于对照组，两组比较差异有统计学意义（P〈0.05）；观察组的复发率为6.3%，对照组的复发率为14.1%，两组比较差异有统计学意义（P〈0.05）。结论采用合适的手术方式并在此基础上进行术中胆道镜探查及取石处理治疗肝内胆管结石并胆管狭窄的临床疗效好，并发症发生率及复发率低，值得临床推广应用。

Effect analysis of operation in the treatment of intrahepatic bile duct stone combined with bile duct stricture

Objective To evaluate the clinical effect of operation in the treatment of intrahepatic bile duct stones com-bined with bile duct stricture. Methods 128 cases of patients with intrahepatic bile duct stone and biliary stricture from March 2011 to December 2013 in our hospital were selected and randomly divided into observation group and control group,64 cases in each group,the control group was operated with appropriate surgical approach,the observation group was given choledochoscope exploration and stone processing on the basis of the control group.Clinical effect,inci-dence rate of complication and recurrence in two groups was observed and compared respectively. Results The excel-lent and good rate in observation group was 96.9%,significantly higher than that in control group（84.4%）,with statistical difference （P〈0.05）.The total incidence rate of complication in observation group was lower than that in control group, with statistical difference （P〈0.05）.The recurrence rate in observation group was 6.3%,the recurrence rate in control group was 14.1%,with statistical difference （P〈0.05）. Conclusion Based on the use of appropriate surgical approach,in-traoperative choledochoscope exploration and stone processing treatment show a good effect in the treatment of intra-hepatic bile duct stone stenosis combined with bile duct stricture,and the incidence rate of complication and recurrence rate are low,and it is worthy of clinical promotion and application.