输尿管硬镜在肝内胆管结石中的应用

目的探讨输尿管硬镜在肝内胆管结石中的临床治疗效果。方法选择乳源瑶族自治县人民医院收治的36例肝内胆管结石患者,随机均分为观察组和对照组(n=18),观察组采用直视下行输尿管硬镜下结石清除术,对照组采用传统的开腹切开胆囊取石,观察比较2组的临床治疗效果。结果 2组患者结石取净率比较差异无统计学意义,观察组结石残留率、手术时间和住院时间分别为11.11%、(92.5±20.6)min和(7.5±3.2)d,明显低对照组44.44%、(128.7±34.2)min和(14.6±3.5)d,2组比较差异具有统计学意义(P<0.05);观察组总有效率达100%,明显高于对照组的83.33%(P<0.05);观察组无1例发生术后并发症,对照组术后发生切口感染1例、胆漏2例,并发症发生率16.67%(3/18),2组比较差异具有统计学意义(P<0.05)。结论采用直视下输尿管硬镜清除结石治疗肝内胆管结石疗效好,结石残留率低,手术时间短、恢复快,无严重并发症发生,值得临床推广应用。

Objective To investigate the clinical effect of hard ureter mirror in intrahepatic bile duct stones. Methods Choose the hospital of 36 patients with intrahepatic bile duct stones were randomly divided into observation group and the control group 18 cases, observation group used look downward ureteral hard microscopically for removal of calculus, the control group with traditional laparotomy incision of gallbladder stone, observe the clinical therapeutic effect of the two groups. Results Two group of patient stones take only lead the comparison difference non-statistics signiifcance, Observation group calculi residual rate, operation time and hospital stay were 11.11%, （92.5±20.6）min and （7.5±3.2）d, obvious low observation group 44.44%, signiifcantly lower than the control group （128.7±34.2）min and （14.6±3.5）d, two group of comparison differences have statistics signiifcance （P〈0.05）;Observation group total effectiveness reaches 100%, is higher than the control group obviously 83.33%（P〈0.05）;After the observation group does not have 1 example to have the technique the complication, after the control group technique has the margin to infect 1 example, to have the cholerrhagia 2 examples, the complication formation rate 16.67%（3/18）, two group of comparison differences has statistics signiifcance （P〈0.05）. Conclusion Using hard look straight into the ureter mirror clear good curative effect in the treatment of intrahepatic bile duct stones, stones residual rate is low, the operation time is short, fast recovery, no serious complications, worthy of clinical popularization and application.