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螺旋水刀结合硬质胆镜治疗肝内胆管结石临床研究 被引量:2

Clinical Research About Freating Intrahepatic Bile Duct Stone by Helix Hydro-jet Under Rigid Choledochoscope
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摘要 目的:探讨螺旋水刀结合硬质胆镜治疗肝内胆管结石的方法。方法:使用德国狼牌硬质胆道镜一台,德国爱尔博公司生产ERBE螺旋水刀一台,内镜手柄直径1.6mm,长3m,喷嘴直径120μm,压力为1~150bar;击碎结石的介质为无菌生理盐水,经硬质胆镜治疗孔插入水刀手柄,喷嘴对准结石,采用压力30~70bar进行碎石,边击碎结石后边吸出。结果:2004年6月至2005年4月治疗肝内胆管结合20例,24次,术中碎石18次,术后经T管窦道碎石6次,每次30m in^1h。对胆镜能发现的结石均能击碎并取净,全组无并发症发生。结论:硬质胆道镜或纤维胆道镜对直径大的胆道结合嵌顿结石取石极为困难,且易在取石过程中造成胆道穿孔、出血等严重并发症,应用螺旋水刀结合硬质胆镜取石则安全,不易造成胆管损伤,且缩短取石时间,无痛苦。本研究探索出一种新的取石方法。 Objective: To study the method of treating intrahepatic bile duct stone by helix -jet under rigid Choledochoscope. Method: Use a german' s "wolf" rigid choledochoscope, use a german' s ERBE company helix hydro - jet. The helix hydro - jet' s endoscope bat - handle' s diameter is 1.6mm, length is 3m, jet nozzle's diameter is 120μm, pressure is 1 - 150bar, medium of smashing stones is aseptic normal saline. Insert t,ydro - jet ' s bar - handle into rigid choledochoscope, aim at stones with jet nozzle, smash stones with pressure 30 - 70bar and draw off stones at the same time. Result: Treating 20 patients with intraheparic bile duct stone between June 2004 to April 2005 , total 24 man - time, smashing stones in operation in 18 cases smashing stones from "T" pipe sinus tract in 6 cases, 30 -60mins every time. It can smash and draw of all the stones discovered by choledoscope. It didn' t happen complications in group. Conclusion: It is difficult to draw off big stones or incarceration stones with rigid choledochoscope or fibre choledochoscope and easy to cause complications as duct bile perforation or duet bile hemorrhage. It can be safe, few damage, shorten operations, painless to smash stones with helix hydro -jet under rigid choledochoscope. We explored a new method to draw off stones in the research.
出处 《河北医学》 CAS 2006年第8期789-790,共2页 Hebei Medicine
关键词 螺旋水刀 硬质胆道镜 Helix hydro - jet Rigid choledoscope
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