胆管支架加中药排石治疗难治性胆总管结石的对照研究

Traditional Chinese Medicine Combined Biliary Stents in the Treatment of Bile Duct Stones

目的探讨胆管支架加口服排石中药对难治性胆总管结石治疗效果。方法收集符合难治性胆总管结石标准的患者80例,均行内镜下逆行胰胆管造影(ERCP)并置入胆管塑料支架,随后分为治疗组(胆管支架+中药)和对照组(胆管支架)。随访6个月后行第2次ERCP拔除支架并再次取石。比较两组间第2次结石大小和取石成功率。结果第1次ERCP时,两组之间在结石类型、平均结石大小等方面差异无统计学意义(P均>0.05)。随访6个月后,联合治疗组的结石大小明显小于对照组(P<0.05)。并且第2次ERCP取石成功率更高(97.5%vs 85.0%,P<0.05)。结论胆管支架加中药排石优于单用胆管支架对胆总管结石的治疗作用。

Objective To evaluate the effect of combination of oral Traditional Chinese medicine and biliary stents in the treatment of difficult bile duct stones.Methods Totally 80 cases of patients with common bile duct stones underwent biliary stent placement at the first ERCP.Then they were divided into treatment group and control group.They underwent a second ERCP and stone removal was attempted after 6 months follow up.Differences in stone size and success rate of stone extraction between groups after stenting were compared.Results At the first ERCP,no statistical significance between the two groups was found with respect to the stone type,the average stone size （P ＞ 0.05）.After 6 months follow up,the mean size of biliary stones was significantly lower in the treatment group than that in the control group （P ＜ 0.05）.The success rate of stone extraction was significantly higher in the treatment group than that in the control group （P ＜ 0.05） at the second ERCP （97.5％ vs 85.0％,P ＜ 0.05）.Conclusion The combination of traditional Chinese medicine and biliary stents in the treatment of difficult bile duct stones is safe and effective.