腹腔镜联合胆道镜和柴胡舒肝汤加减治疗胆管结石的临床效果观察

Clinical effect observation of laparoscopy combined with choledochoscopy and Modified Chaihu Shugan Decoction in the treatment of bile duct stones

目的探讨腹腔镜联合胆道镜和柴胡舒肝汤加减治疗胆管结石的临床效果。方法选取我院2014年12月~2016年12月收治的120例胆管结石患者作为研究对象,按照治疗方式的不同分为研究组(50例)、对照组1(32例)、对照组2(38例)。对照组1采用腹腔镜联合胆道镜进行手术,对照组2采用传统的开腹手术治疗,研究组采用腹腔镜联合胆道镜和柴胡舒肝汤加减治疗,比较三组的临床疗效和术后恢复情况。结果研究组和对照组1的手术时间短于对照组2,术中出血量少于对照组2,结石清除率高于对照组2,差异有统计学意义(P<0.05)。研究组的结石清除率显著高于对照组1,差异有统计学意义(P<0.05)。研究组和对照组1的胃肠功能恢复时间、住院时间短于对照组2,并发症发生率低于对照组2,差异有统计学意义(P<0.05)。研究组的并发症发生率低于对照组1,差异有统计学意义(P<0.05)。结论腹腔镜联合胆道镜和柴胡舒肝汤加减治疗胆管结石效果显著,能够有效缩短手术时间及术后住院时间,减少术中出血量,提高结石清除率,有利于术后胃肠功能恢复,降低术后并发症发生率。

Objective To explore the clinical efficacy of laparoscopy combined with choledochoscopy and Modified Chaihu Shugan Decoction in the treatment of bile duct stones.Methods 120 patients with bile duct stones admitted to our hospital from December 2014 to December 2016 were selected as research subjects,all patients were divided into the study group （50 cases）,the control group 1 （32 cases）,the control group 2 （ 38 cases） according to the different treatment methods.The control group 1 was treated with laparoscopy combined with choledochoscopy surgery,the control group 2 was treated with traditional open surgery,the study group was treated with laparoscopy combined with choledo- choscopy and Chaihu Shugan decoction.The clinical efficacy and postoperative recovery of the three groups were com- pared.Results The operation time of the study group and the control group 1 was shorter than that of the control group 2,and the blood loss of the study group and the control group 1 was less than that of the control group 2,and the stone clearance rate of the study group and the control group 1 was higher than that of the control group 2,with significant difference （P〈0.05）.The stone clearance rate in the study group was significantly higher than that in the control group 1, with significant difference （P〈0.05）.The gastrointestinal function recovery time,hospitalization time of the study group and the control group 1 was shorter than that the control group 2,the incidence rate of complications of the study group and the control group 1 was lower than that of the control group 2,with significant difference （P〈0.05）.The incidence rate of complications in the study group was lower than that in the control group 1,with significant difference （P〈0.05）.Con- chlsion Laparoscopy combine d with choledochoseopy and ChaiHu ShuGan Decoction in the treatment of bile duct stones has significant effect,can effectively shorten the operation time and hospitalization time after operation,reduce the amount of bleeding,improve the stone clearance rate,is conducive to the recovery of gastrointestinal function after surgery,reduce the incidence of postoperative complications.