不同方法治疗肝内胆管结石的临床疗效与预后观察

目的 探讨不同手术方法治疗肝内胆管结石的临床效果.方法 对2012年5月～2013年11月来我院住院接受手术治疗的66例肝内胆管结石患者的临床资料进行回顾性分析,按治疗方法分为两组,观察组40例采用腹腔镜微创治疗,对照组26例行开腹肝切除术治疗,比较两组手术时间、术后下床时间、术中出血量、治疗有效率及并发症发生情况.结果 观察组的手术时间及术后下床时间与对照组比较明显较短,术中出血量也较少,差异有统计学意义（P＜0.05）.观察组的有效率（92.5％）与对照组（76.92％）比较明显较高,差异有统计学意义（P＜0.05）.观察组的并发症发生率（15％）与对照组（34.62％）比较明显较低,差异有统计学意义（P＜ 0.05）,而两组结石复发率、胆管感染率、切口感染率差异无统计学意义（P＞0.05）.结论 肝内胆管结石患者采用腹腔镜联合纤维胆道镜微创治疗能使患者的临床症状体征显著缓解,疗效较为满意.

The clinical efficacy of different methods of treatment and prognosis of intrahepatic bile duct stones

Objective To investigate the clinical effects of different surgical methods for treating intrahepatic bile duct stones. Methods The clinical data of 66 cases with intrahepatic bile duct stones collected from May 2012 to November 2013 in our hospital for surgery were retrospectively analyzed, they were divided into two groups according to the treatment method, the observation group with 40 cases used laparoscopic micro-invasive treatment, control group with with 26 cases used open liver resection, the operative time, postoperative ambulation time, blood loss, treatment effi- ciency and the occurrence of complications of two groups were compared. Results The operative time and postoperative ambulation time of observation group was significantly shorter than the control group, blood loss was less than control groups, the difference was statistically significant（P 〈 0.05）. The efficiency of the observation group （92.5%） Was higher than the control group （76.92%）, the difference was significant （P 〈 0.05）. The complication rate in the observation group （15%） was lower than the control group （34.62%）, the difference was significant （P 〈 0.05）, while there were no significant difference in the stone recurrence rate, biliary infection, wound infection rate between two groups（P 〉 0,05）. Conclusion Laparoseopic patients with intrahepatic bile duct stones combined Choledochofiberscope minimally invasive treatment of patients with clinical signs and symptoms can significantly ease, efficacy is satisfactory.