自拟中药方结合腹腔镜联合胆道镜手术治疗肝内外胆管结石疗效观察

Curative Effect of Applying Self-Drafting Traditional Chinese Medicine Prescription and Laparoscopy Combined with Choledochoscopy in the Treatment of Intrahepatic and Extrahepatic Bile Duct Stones

目的:观察自拟中药方结合腹腔镜联合胆道镜手术治疗肝内外胆管结石患者临床疗效。方法:通过对我院2013年1月~2016年12月就诊收治的80例肝内外胆管结石患者临床资料做回顾性分析。并根据治疗方式的不同分为观察组、对照组各40例。比较并分析两组患者的临床疗效、治疗后第1天、3天、5天、7天、15天、30天胆汁引流量情况等。结果:观察组的治疗总治愈率(90.00%)明显高于对照组(70.00%),差异具有统计学意义(P<0.05),两组患者治疗后第1天、3天、15天、30天胆汁引流量比较无明显差异,具有可比性(P>0.05),治疗后5天、7天观察组胆汁引流量明显高于对照组,差异具有统计学意义(P<0.05),且观察组治疗第7d后胆汁量引流基本处于稳定,对照组在治疗15天后胆汁引流量才接近稳定,两组患者治疗后并发症总发生率(15.00%/12.50%)比较无统计学意义,具有可比性。结论:在肝内外胆管结石患者中应用自拟中药方结合腹腔镜联合胆道镜手术治疗,临床排石疗效显著,且能促进胆汁引流,改善临床症状,值得临床推广。

Objective:To investigate the curative effect of applying self-drafting TCM prescription and laparoscopy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones. Methods:The clinical data of 80 patients with intrahepatic and extrahepatic bile duct stones treated in our hospital from January 2013 to December 2016 were retrospectively analyzed. According to different treatment methods,the patients were divided into observation group and controlled group with 40 cases in each group. The clinical efficacy and volume of biliary drainage were compared and analyzed between the two groups at 1 st day,3 rd day,5 th day,7 th day,15 th day and 30 th day after treatment. Results:The total cure rate in the observation group was 90.00%,which was significantly higher than 70.00% in the controlled group,the difference was statistically significant(P<0.05). The volume of biliary drainage showed no significant difference between the two groups at 1 st day,3 rd day,5 th day,7 th day,15 th day and 30 th day after treatment(P>0.05). After 5 days and 7 days of the treatment,the volume of biliary drainage in the observation group was significantly higher than that in the controlled group(P<0.05),and the biliary drainage was basically stable in the observation group at the 7 th day after treatment,while it took 15 days in the controlled group to be steady. The total complication rate after treatment in both groups(15.00%/12.50%) was not statistically significant but comparable. Conclusion:In the treatment of patients with intrahepatic and extrahepatic bile duct stones,the application of self-drafting TCM prescription and laparoscopy combined with choledochoscopy is effective in stone removal and bile drainage,which can ameliorate clinical symptoms,it is worthy of clinical promotion.