经胆囊管胆道与鼻胆管引流的对比研究

目的比较在胆总管一期缝合术中经胆囊管胆道引流与鼻胆管引流的临床疗效。方法回顾性分析2016年11月-2018年11月郯城县第一人民医院收治的100例胆囊结石合并胆总管结石患者的临床资料,根据引流方式不同分为观察组和对照组各50例,对照组给予胆总管一期缝合经鼻胆管引流术治疗,观察组给予胆总管一期缝合经胆囊管胆道引流术治疗。比较两组手术时间、术中出血量、引流管放置时间、胃肠功能恢复时间、住院时间、每日引流量、肝功能指标及并发症发生率。结果观察组手术时间短于对照组,引流管放置时间长于对照组,差异均有统计学意义(P<0.05)。两组术中出血量、胃肠功能恢复时间、术后住院时间、每日引流量、肝功能指标及并发症发生率比较,差异均无统计学意义(P>0.05);术后随访12个月,超声检查两组均未见胆管结石和狭窄,且肝功能正常。结论经胆囊管胆道引流与鼻胆管引流均可达到胆道引流的目的,维护胆道生理功能,前者可缩短手术时间,后者可缩短引流管放置时间,二者均有良好的治疗效果。

Comparison study of transcystic biliary drainage and nasobiliary drainage

Objective To compare clinical curative effect of primary suture of common bile duct through transcystic biliary drainage and nasobiliary drainage. Methods The clinical data of 100 patients with cholecystolithiasis and common bile duct stones who were admitted to the First People’s Hospital of Tancheng County from November 2016 to November 2018 were retrospectively analyzed. According to different drainage methods,they were divided into observation group and control group with 50 cases in each group. The control group was treated with primary suture of common bile duct and nasobiliary drainage,while the observation group was treated with primary suture of common bile duct and transcystic biliary drainage. The operation time,intraoperative blood loss,placement time of drainage tube,recovery time of gastrointestinal function,hospitalization time,daily drainage volume,liver function indexes and incidence of complications were compared between the two groups. Results The operation time in observation group was shorter than that in control group,while placement time of drainage tube was longer than that in control group,and the differences were statistically significant(P <0.05). There were no significant differences in intraoperative blood loss,recovery time of gastrointestinal function,postoperative hospitalization time,daily drainage volume, liver function indexes and incidence of complications between the two groups(P>0.05). After 12-month follow-up,there was no bile duct stones and strictures in two groups by ultrasound examination,and liver function was normal. Conclusion Both transcytic biliary drainage and nasobiliary drainage could achieve bile duct drainage and maintain physiological function of bile duct. The former could shorten operation time,while the latter could shorten placement time of drainage tube,both had good therapeutic effect.