胆道镜下微爆破碎石仪治疗难取性胆道结石76例临床分析

Clinical study on micro-blasting lithotripsy and cholangioscopy for 76 cases of refractory biliary passage lithiasis

目的:探讨对胆道难取性结石实施碎石治疗的方法、疗效和安全性.方法:实验组为2005-12/2008-11采用iMES-I型体内微爆破碎石仪联合胆道镜治疗的难取性胆道结石76例,对照组为2002-01/2005-12通过纤维胆道镜治疗的类似胆道结石患者60例,比较两组的治疗效果和并发症发生率.结果:实验组结石取净率为97.4%,其中肝内胆管结石取净率为93.3%,肝外胆管结石取净率为100%,均显著高于对照组61.7%,48.1%,72.7%(P<0.01).两组均无胆道大出血、穿孔及胆瘘等严重并发症发生,胆道粘膜渗血、发热、肝功异常等反应两组之间无显著性差异.结论:体内微爆破碎石仪可显著提高胆道难取性结石的治疗效果,安全可靠,适于临床推广.

AIM：To explore the applicability,curative effect and safety of micro-blasting lithotripsy for refractory biliary lithiasis.METHODS：Seventy-six cases of refractory biliary lithiasis were in experiment group that were cured by type iMES-I micro-blasting lithotrite meter and cholangioscopy from December 2005 to November 2008.Sixty cases were in control group that were cured by cholangioscopy from January 2002 to December 2005.Curative effect and concurrent disease were compared between two groups.RESULTS：In experiment group,the clearance rate of biliary lithiasis was 97.4%,and the clearance rate of intra-and extre-biliary lithiasis were 93.3% and 100%.They were predominance higher than control group 61.7%,48.1% and 72.7%（P0.01）.No obvious adverse effect was occurrence in 2 groups.The rate of hemobilia,fever,and dysfunction of liver was no significant different between 2 groups.CONCLUSION：Micro-blasting lithotrite meter can improve the curative effect of refractory biliary passage stone.It was safety and should be spread in the clinic.