手术+胆道镜+中药+针灸联合应用治疗Ⅱ型肝胆管结石病

Therapeutic effects of combinations of surgery,choledochoscope,herbal therapy and acupuncture on typeⅡ hepatolithiasis

目的探讨多手段联合应用治疗对Ⅱ型肝胆管结石病的影响。方法把Ⅱ型肝内胆管结石患者分成A、B、C 3个治疗组,每组30例。A组行常规手术+胆道镜治疗;B组在A组基础上加用中药治疗;C组在B组基础上加用针灸治疗。观察3组患者术后胆道镜次数、治疗后结石取净率、1年内结石复发率、再手术率及疗效的差异。结果 3组患者均按要求完成治疗及随访,术后1个月肝功能指标均恢复正常。3组术后胆道镜次数比较,差异有统计学意义(P <0.05);治疗后结石取净率、1年内结石复发率、再手术例数及疗效评价比较,差异无统计学意义(P> 0.05)。结论多手段联合应用治疗Ⅱ型肝胆管结石病有效,但差异无统计学意义,有待增加治疗量,进一步观察总结。

Objective To explore the effect of multiple treatments on typeⅡhepatolithiasis.Methods Patients with typeⅡhepatolithiasis were divided into group A,B and C,with 30 patients in each group.Patients in group A underwent surgery and choledochoscope.Combinative therapy including surgery,choledochoscope and herbal therapy was applied in group B.Combination of surgery,choledochoscope,herbal therapy and acupuncture was for group C.The differences of cure rate,1-year recurrence and re-surgery among 3 groups were compared.Results All the patients were treated and followed up as required,and the liver function returned to normal 1 month after the surgery.Comparison of the number of choledochoscopy in the 3 groups after the surgery showed statistical significance(P<0.05)but the number of recurrence rate of stone in 1 year and the efficacy evaluation in the 3 groups had no difference(P>0.05).Conclusion Multiple therapeutic strategies may be effective in the treatment for typeⅡhepatolithiasis and further investigation is needed to confirm the efficacy.