FREDDY激光联合胆道镜治疗胆道残余结石的临床分析

Clinical Analysis of FREDDY Laser Combined with Cholangioscopy for the Treatment of Biliary Residual Stones

目的对比单纯应用胆道镜和胆道镜联合FREDDY激光在治疗胆道残余结石中的不同效果,分析FREDDY激光碎石在治疗胆道结石中的作用及疗效。方法回顾该院2012年1月—2015年12月治疗胆总管切开取石+T管引流术后,肝内胆管残余结石临床病例,共86例,其中应用胆道镜组(45例),胆道镜联合FREDDY激光组(41例),对比分析两组在手术时间、手术中出血量、术后残余结石比率、术中疼痛耐受程度等指标。结果 86例手术均顺利完成,在手术中出血量上两组差异无统计学意义(P>0.05),而在手术时间观察组(106.8±7.05)min,对照组:(134.8±5.15)min、术后残余结石(观察组:3/41,对照组:11/45)、术中疼痛耐受程度(观察组:40/41,对照组:36/45)等指标上,胆道镜联合FREDDY激光组明显优于单纯应用胆道镜组,差异有统计学意义(P<0.05)。结论 FREDDY激光具有安全、高效、便捷、病人耐受良好等一系列显著优点,值得临床推广应用。

Objective To evaluate the effect of FREDDY laser lithotripsy for the treatment of biliary calculi by comparing the effect of using Cholangioscopy or FREDDY laser lithotripsy combined with Cholangioscopy. Methods Eighty-six patients with residual stone of intrahepatic bile duct undergoing choledocholithotomy of common bile duct were analyzed retrospectively in our hospital from January 2012 to December 2015.There were 45 patients in Cholangioscopy group and 41 patients in FREDDY laser lithotripsy group.Operative time,intraoprative blood loss,postoperative residual stone rate, tolerance level of intraoperative pain were compared. Results 86 patients were carried out successfully. There were no statistically significant differences in intraoprative blood loss between the two groups（P〉0.05）.Operation timeobservation group（106.8±7.05）minutes,control group（134.8±5.15） minutes, postoperative residual stone（observation group： 3/41, control group： 11/45）, tolerance level of intraoperative pain（observation group：40/41,control group：36/45） in FREDDY laser lithotripsy group was significantly better than Cholangioscopy group.（P 0.05）. Conclusion It is safe, effective, convenient and well-tolerated by using FREDDY laser.It is worthy of clinical application.