肝内胆管结石肝切除术的治疗效果及相关因素分析

Analysis of Treatment Effects and Related Factors of Hepatolithiasis Liver Resection

目的探讨肝内胆管结石肝切除术的治疗效果及其术后并发症的相关因素。方法回顾性分析了2007年6月至2012年6月入住我院的100例行肝内胆管结石肝切除术患者的临床资料,对该手术方式的临床治疗效果进行分析。然后根据术后是否发生并发症,分为并发症组与非并发症组,对引起并发症的危险因素进行分析。结果①本组100例患者均获得1年的随访,随访率100%。术后B超及T管造影观察结石残留率为12.0%(12/100),11例经T管胆道镜取石均获得痊愈(占11.0%),再发胆道感染3例(占3.0%),总体手术治疗优良者96例,治疗优良率96例,优良率为96.0%。②本组患者术后并发症发生率为34.0%,经Logistic回归分析,结果表明胆道手术史与手术时间是术后出现并发症的主要危险因素(P<0.05,P<0.01)。结论胆内胆管结石切除术后并发症发生的主要危险因素为胆道手术以及手术时间,应对这两个方面加以注意,提高手术技巧以及尽量缩短手术时间,最终降低或避免术后发生并发症。

Objective To investigate the therapeutic effect and its related factors of postoperative complications of hepatolithiasis liver resection.Methods 100 cases of patients with intrahepatic bile duct stones liver resection to stay in our hospital were retrospectively analyzed from June 2007 to June 2012,the surgical approach of clinical treatment effect was analyzed.Whether based on postoperative complications,is divided into a complications set of non-complication group,the analysis of the risk factors that cause complications.Results ①The group of 100 patients have received one-year follow-up,follow-up rate of 100%.Postoperative B-and T-tube cholangiography observed residual stone rate was 12.0%（12/100）,11 cases of T-tube cholangioscopy stone were recovered（11.0%）,recurrent biliary tract infection in 3 cases（3.0%）,general surgery excellent 96 cases,the treatment excellent rate of 96 cases,good rate of 96.0%.②in this group of patients with postoperative complications was 34.0% Logistic regression analysis,the results show that biliary surgery and surgery time postoperative complications,risk factors（P0.05,P0.01）.Conclusion The biliary bile duct stones resection major risk factors for biliary tract surgery,and surgery time,deal with these two aspects of attention,improve surgical techniques and try to shorten the operation time,and ultimately reduce or avoid postoperative complications postoperative complications occurred.