熊去氧胆酸对腹腔镜胆总管结石取石术后结石再发的预防及肝功能恢复的影响

Effect of ursodeoxycholic acid on prevention of recurrence of calculi and recovery of liver function after laparoscopic choledocholithotomy

目的探究熊去氧胆酸(UDCA)对腹腔镜胆总管结石取石术后结石再发的预防及肝功能恢复的影响。方法 120例胆总管结石患者,按照随机数字表法分为观察组和对照组,各60例。对照组患者采用腹腔镜胆总管结石取石术治疗,观察组在对照组基础上加用UDCA治疗。比较两组患者的临床疗效、治疗前后肝功能指标[总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(GGT)]变化及结石复发情况。结果观察组治疗总有效率为95.00%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗前,两组TBil、ALT、AST、GGT比较,差异无统计学意义(P>0.05);治疗后,观察组TBil、ALT、AST、GGT均低于对照组,差异有统计学意义(P<0.05)。观察组结石复发率为6.67%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论腹腔镜胆总管结石取石术后给予UDCA治疗可有效降低结石复发率,有利于改善肝功能水平,促进预后恢复,在临床应用中具有推广价值。

Objective To investigate the effect of ursodeoxycholic acid (UDCA) on prevention of recurrence of calculi and recovery of liver function after laparoscopic choledocholithotomy. Methods A total of 120 choledocholithiasis patients were divided into observation group and control group according to random number table method, with 60 cases in each group. The control group was treated with laparoscopic choledocholithotomy, and the observation group was treated with UDCA on the basis of the control group. Comparison were made on clinical efficacy, changes of liver function indexes[ total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST),γ-glutamyltransferase (GGT)] and stone recurrence before and after treatment between the two groups. Results The observation group had higher total treatment effective rate as 95.00% than 75.00% in the control group, and the difference was statistically significant (P<0.05). Before treatment, both groups had no statistically significant difference in TBil, ALT, AST and GGT (P>0.05). After treatment, the observation group had lower TBil, ALT, AST and GGT than the control group, and their difference was statistically significant (P<0.05). The observation group had lower stone recurrence rate as 6.67% than 20.00% in the control group, and the difference was statistically significant (P<0.05). Conclusion UDCA therapy after laparoscopic choledocholithotomy can effectively reduce the recurrence rate of calculi, help to improve liver function level, and promote the recovery of prognosis. It is worth popularizing in clinical application.