保胆取石术后口服牛磺熊去氧胆酸预防结石复发的临床观察

A Clinical Study on Tauro Ursodeoxycholic Acid for the Relapse of Cholelithiasis after Gallbladder-Protected Lithotomy

目的评价选择性保胆取石术后口服牛磺熊去氧胆酸预防胆囊结石复发的临床价值。方法将成都军区总医院2004年至2008年符合微创保胆取石术条件的80例胆囊结石患者按随机序列表分为两组,每组各40例。两组患者均经微创保胆取石术后保留功能良好的胆囊,治疗组患者术后口服牛磺熊去氧胆酸2年,对照组患者除不用服药外,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,统计胆结石症状和胆囊结石复发率。结果两组患者保胆取石术均获成功。术后2年治疗组和对照组胆囊壁厚度差值、胆囊收缩功能差值的差异均有统计学意义(P<0.05),术后2年治疗组结石复发明显减少(P<0.05)。结论保胆取石术后患者口服牛磺熊去氧胆酸对胆囊结石的复发有预防作用。

To evaluate the clinical application value of the tauro ursodeoxycholic acid （TUDCA） for preventing the relapse of lithiasis after the gallbladder-protected lithotomy. Methods Totally 80 cholecyslithiasis patients in Chengdu General Military Hospital who met the demand of lithotomy in protecting gallbladder were divided into two groups by random permutations, with 40 patients in each. The calculus was removed by using the percutaneous ultrasonic lithotripsy in order to preserve the well-functioning gallbladder. The patients in the trial group were given TUDCA after surgery for two years, whereas the patients in the control group received the same nursing and diet therapies without medication. The thickness of gallbladder wall and the contraction function of gallbladder were checked two years after surgery, the statistics of the recurrence rate of liary calculus symptoms and cholecyslithiasis were conducted, and the comparison between those two groups was performed. Results All the operations of gallbladder-protected lithotomy were successful. There was significant difference between those two groups two years after surgery in terms of the thickness of gallbladder wall and the contraction function of gallbladder （P〈0.05）. The relapse of lithiasis was remarkably decreased in the trial group （P〈0.05）. Conclusion The application of TUDCA for patients with gallbladder-protected lithotomy can prevent the relapse of cholecyslithiasis.