利胆防石散对微创保胆取石术后胆囊结石复发的预防作用

Preventative Effect of Lidanfangshi Powder on Relapse of Lithiasis after Microinvasive Gallbladder-protected Lithotomy

目的评价选择性保胆取石术后利胆防石散内服预防胆囊结石复发的临床应用价值。方法将我院2007—2009年符合内镜微创保胆取石术条件的60例胆囊结石患者,按随机排列表将患者分为两组,各30例。两组患者通过腹腔镜切开胆囊底,应用纤维胆道镜进行取石,保留功能良好的胆囊。治疗组患者术后5d服利胆防石散3个月。对照组患者除不服利胆防石散外,其余护理、饮食等与治疗组相同。术后2年复查胆囊壁厚度及胆囊收缩功能,比较两组有无差异。结果60例保胆取石术均获成功,无严重并发症,3～5d均痊愈出院。两组患者术前胆囊壁厚度、胆囊收缩功能间差异均无统计学意义(P>0.05),术后2年两组患者胆囊壁厚度、胆囊收缩功能间差异均有统计学意义(P<0.05)。结论保胆取石术后患者服用利胆防石散,能使胆囊壁的厚度明显减少,既能减轻胆囊的炎症反应,还能增强胆囊的收缩功能,对胆囊结石的复发有一定的预防作用。

Objective To evaluate the clinical application of Lidanfangshi powder （Chinese medicinal preparation） for preventing the relapse of lithiasis after the alternative microinvasive gallbladder-protected lithotomy.Methods Totally 60 patients in our hospital who met the demand of endoscopic microinvasive cholecystolithotomy in protecting gallbladder were by random permutations divided into two groups,with 30 in each.The bottom of gallbladder of the patients in both groups was incised by using laparoscope,and then the calculus was removed by using the choledochofiberscope in order to preserve the well-functioning gallbladder.The patients in the trial group were given Lidanfangshi powder 5 days after surgery for 3 months.The same nursing and diet therapies were given for the patients in the control group except for medication of the powder.Results All the operations of microinvasive gallbladder-protected lithotomy for the 60 patients were successful.No serious complication appeared.All the patients were recovered and discharged from hospital from the 3 to 5 days.In discrepancies of the thickness of gallbladder wall and the function of gallbladder contraction there was no statistical significance between the two groups before surgery （P〉0.05）,however,there was two years after the operation （P〈0.05）.Conclusion Application of Lidanfangshi powder for patients received microinvasive gallbladder-protected lithotomy can reduce the thickness of gallbladder wall,relieve the inflammatory reaction,and enhance the contraction function of gallbladder so as to prevent the relapse of cholelithiasis.