经腹胆双镜术联合茵陈柴胡汤治疗胆囊结石合并胆总管结石的效果

Effect of laparoscopic combined choledochoscopic surgery combined with Yinchen Chaihu decoction in the treatment of cholecystolithiasis with choledocholithiasis

目的研究经腹胆双镜术联合茵陈柴胡汤治疗胆囊结石合并胆总管结石的效果。方法选取我院2016年4月至2017年6月收治的104例胆囊结石合并胆总管结石患者作为研究对象,按照随机数字法表将其分为对照组与研究组,各52例。对照组采用经腹胆双镜术治疗,研究组选用经腹胆双镜术联合茵陈柴胡汤治疗。比较两组治疗效果。结果治疗后,两组上腹饱胀、恶心呕吐、压痛及腹痛评分均降低,且研究组低于对照组(P<0.05)。治疗后,两组TBA、AST及GPT水平均降低,且研究组低于对照组(P<0.05)。研究组的治疗总有效率高于对照组(P<0.05)。研究组肛门排气时间、住院时间短于对照组,术中出血量少于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论经腹胆双镜术联合茵陈柴胡汤治疗胆囊结石合并胆总管结石的效果显著,可有效改善患者的肝胆功能与临床症状,还可缩短术后肛门排气时间、住院时间,减少术中出血量与并发症的发生,值得推广应用。

Objective To study the effect of laparoscopic combined choledochoscopic surgery combined with Yinchen Chaihu decoction in the treatment of cholecystolithiasis with choledocholithiasis.Methods A total of 104 patients with cholecystolithiasis and choledocholithiasis admitted in our hospital from April 2016 to June 2017 were selected as the research objects,they were divided into control group and study group according to random number table method,with 52 cases in each group.The control group was treated with laparoscopic combined choledochoscopic surgery,while the study group was treated with laparoscopic combined choledochoscopic surgery combined with Yinchen Chaihu decoction.The therapeutic effects of the two groups were compared.Results After treatment,the scores of upper abdominal fullness,nausea and vomiting,tenderness and abdominal pain in the both groups decreased,and those in the study group were lower than the control group(P<0.05).After treatment,the levels of TBA,AST and GPT in the two groups decreased,and those in the study group were lower than the control group(P<0.05).The total effective rate of treatment in the study group was higher than that of the control group(P<0.05).The time of anal exhaust and hospitalization in the study group were shorter than those in the control group,and the amount of intraoperative blood loss was less than that in the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion Laparoscopic combined choledochoscopic surgery combined with Yinchen Chaihu decoction is effective in the treatment of cholecystolithiasis with choledocholithiasis.It can effectively improve the liver,gallbladder function and clinical symptoms of patients,shorten the time of anal exhaust and hospitalization after operation,reduce the amount of intraoperative blood loss and complications.It is worth popularizing and applying.