术前放置鼻胆管联合一期缝合术对胆总管结石疗效及不良事件的干预效果

Intervention effect of preoperative placement of nasobiliary drainage tube combined with primary suture on choledocholithiasis and adverse events

目的：分析术前放置鼻胆管联合一期缝合术治疗胆总管结石的疗效及安全性。方法将72例胆总管结石患者随机分为对照组与观察组，每组各36例，对照组采取 T 管引流术治疗，观察组则行术前放置鼻胆管联合一期缝合术，比较两组患者手术时间、术中出血量、并发症等指标。结果观察组与对照组引流时间[（5.52±1.27）d 比（13.25±2.03）d]、胃肠功能恢复时间[（35.78±5.64）h 比（54.79±6.83）h]及住院时间[（10.34±1.40）d 比（22.92±2.94）d]比较差异有统计学意义（P 〈0.05）。观察组感染率明显低于对照组（P 〈0.05），观察组发生胆漏1例，对照组发生胆漏3例，两组均无胆道狭窄发生。结论术前放置鼻胆管联合一期缝合术能明显缩短胆总管结石患者引流时间，促胃肠功能快速回复，住院时间相对短，且并发症少，安全可行。

Objective To study the effect and safety of preoperative placement of nasobiliary drainage tube combined with primary suture on choledocholithiasis. Methods A total of 72 patients with choledocholithiasis were selected as the clinical research objects,and these patients were randomly divid-ed into observation group（36 cases）and control group（36 cases）. Patients in the control group were given T-tube drainage,and the other patients in the observation group were given preoperative placement of nasobiliary drainage tube combined with primary suture. After treatment,the operation time,intraop-erative blood loss and complications were observed and compared. Results The drainage time,gastroin-testinal function recovery time and hospital stay of the observation group were respectively（5. 52 ± 1. 27） d,（35. 78 ± 5. 64）h and（10. 34 ± 1. 40）d ,which were significantly shorter than those of the control group[（13. 25 ± 2. 03）d,（54. 79 ± 6. 83）h and（22. 92 ± 2. 94）d]（P 〈 0. 05）,and also the infection rate of the observation group was lower than that of the control group（ P 〈 0. 05）. In the observation group,bile leakage appeared in 1 patient,but in the control group,bile leakage appeared in 3 patients, and there was no biliary stricture occurred in the two groups. Conclusions Preoperative placement of na-sobiliary drainage tube combined with primary suture which can significantly shorten the drainage time of patients with choledocholithiasis and promote the rapid recovery of gastrointestinal function has the advan-tage of shorter hospital stay,less complication and more safety.