输尿管镜气压弹道碎石取石术治疗胆道结石的疗效及安全性探讨

The Efficacy and Safety of the Transureteroscopic Pneumatic Lithotripsy in the Treatment of Biliary Stone

目的探讨输尿管镜气压弹道碎石取石术治疗胆道结石的疗效及安全性。方法利用输尿管镜气压弹道碎石取石技术治疗肝内外胆管结石151例(输尿管镜组),与以往采用胆道镜取石的100例患者(胆道镜组)进行回顾性病例对照研究。结果与胆道镜组相比,输尿管镜组在手术时间、取石时间上具有明显优势(P<0.05),而在术后住院时间、术中出血量及术后胃肠道恢复功能时间上无明显差异(P>0.05)。两组患者治疗后6～8周复查B超及胆道造影,输尿管镜组100例病例肝外胆道内发现残留结石2例,残石率1.3%;无一例出现胆道出血、胆漏、肝功能损害及并发胰腺炎。输尿管镜组90例病例肝外胆道内未发现残留结石,残石率10%;并发胆道出血1例、胆漏2例、胰腺炎1例,均经保守治疗治愈。输尿管镜组术后残石率明显低于胆道镜组(P<0.01);而两组患者并发症发生率比较无统计学差异(P>0.05)。结论输尿管镜气压弹道碎石取石术治疗肝内外管结石有效、安全。

Objective To explore the efficacy and safety of ureteroscopic pneumatic lithotripsy for the treatment of biliary stones. Methods A retrospective analysis was carried out in 151 cases treated by uret- eroscopie pneumatic lithotripsy and 100 cases by cholangioseopic lithotripsy. Results Compared with the choledochoscope group, the ureteroscope group had a clear advantage in operation time and stone extraction time （ P 〈 O. 05 ） , and had no difference in the postoperative hospitalization time, blood loss and the gastrointestinal recovery time （P 〉 0.05 ）. The residual rate was 1.3% of the ureteroscope group, which was much lower than the choledochoscope group （ P 〈 0. O1 ）. There was no difference in the postoperative complications, such as biliary duct hemorrhage, bile leakage and pancreatitis, etc （P 〉 O. 05）. Conclusion It is effective and safe of the ureteroscopic pneumatic ballistic lithotripsy for the treatment of cholelithiasis.