胆汁回输在胆总管切开T管引流术中的临床应用

Clinical application of bile reinfusion in T tube drainage after common bile duct exploration

目的:探讨胆汁回输对胆总管切开T管引流术患者术后恢复的临床效果。方法:将80例胆道疾病手术患者随机分为观察组(40例)、对照组(40例),观察组进行胆汁回输,对照组不进行胆汁回输,术后第3 d和第7 d检测两组患者肝功能、C反应蛋白(C-reactive protein,CRP)的变化,并观察两组患者胃肠恢复时间,住院时间,每日补液量,电解质紊乱情况的变化。结果:术后第7 d,观察组的营养状况优于对照组(P<0.05),肝功能指标(总胆红素,碱性磷酸酶,丙胺酸转氨酶,天门冬氨酸转移酶)低于对照组(P<0.05),而总蛋白及白蛋白水平高于对照组(P<0.05);CRP水平低于对照组(P<0.05)。住院期间观察组患者静脉补液量少于对照组(P<0.05),电解质紊乱发生率低于对照组(P<0.05);两组患者术后胃肠恢复时间比较差异无统计学意义(P>0.05);而观察组的住院时间短于对照组(P<0.05)。结论:胆汁回输可明显改善患者肝功能及肠内营养状况,减少并发症的发生,并缩短住院时间,操作简单,具有临床应用价值。

Objective ： To investigate the clinical effect of bile reinfusion on postoperative recovery of patients with T tube drainage after common bile duct exploration. Methods：80 cases of patients undergoing biliary tract surgery were randomly divided into observation gToup （ with bile reinfu- sion） and control group （without bile reinfusion）, 40 cases in each group. On the 3rd and 7th day after operation, the changes of liver function and cardiopulmonary resuscitation （CPR） were detected and the changes of gastrointestinal recovery time, hospitalization time, daily amount of fluid and electrolyte disturbances were observed in the two groups. Results：On the 7th day after operation, the nutritional status in observation group was better than that in control group （ P 〈 0.05） ; liver function index （total bilirubin, alkaline phosphatase, alanine aminotransferase and aspartate aminotrans- ferase） were lower than those in control group （ P 〈0.05） ; the total protein and albumin levels were higher than those in control group （ P 〈0. 05 ） ; CPR level was lower than that in control group （ P 〈 0.05 ）. During hospitalization, the intravenous infusion amount was less than that in con- trol group （ P 〈 0.05 ） ; the incidence rate of electrolyte disorder was lower than that in control group （ P 〈 0.05 ） ; there was no significant difference in postoperative gastrointestinal recovery time between the two groups （ P 〉 0.05 ） ; and the hospitalization time in observation group was shorter than that in control group （ P 〈 0.05 ）. Conclusion： Bile reinfusion, with simple operation, can significantly improve liver function and nutritional status in patients, reduce the incidence of complications and shorten the length of stay in hospital, which has clinical application value.