胆道镜联合钬激光与液电碎石治疗肝内胆管结石的效果比较

Comparison of Choledochoscope Combined with Holmium Laser and Hydroelectric Lithotripsy in Treating Intrahepatic Bile Duct Stones

目的:探讨胆道镜联合钬激光与胆道镜液电碎石治疗肝内胆管结石的效果。方法:选取2019年1月-2020年2月笔者所在医院收治的肝内胆管结石患者98例,按随机数字表法分为观察组(49例)和对照组(49例),对照组予胆道镜液电碎石治疗,观察组予胆道镜联合钬激光治疗。对比两组手术指标(手术次数、总手术时间、单次费用和总住院时间、总费用)、并发症及结石取净率。结果:观察组单次治疗费用显著高于对照组(P<0.05),但手术次数、总手术时间和总住院时间、总费用显著低于对照组(P<0.05);观察组腹部不适、腹泻、发热等并发症发生率低于对照组(P<0.05),且结石取净率略高于对照组,但差异无统计学意义(P>0.05)。结论:与液电碎石术相比,胆道镜联合钬激光碎石术具有操作灵活、创伤小的优点,可有效提升碎石质量,降低术后并发症,减轻患者经济压力。

Objective:To explore the effect of choledochoscope combined with holmium laser and choledochoscope hydroelectric lithotripsy on intrahepatic bile duct stones.Method:A total of 98 patients with intrahepatic bile duct stones admitted in our hospital from January 2019 to February 2020 were selected and divided into observation group(49 cases)and control group(49 cases)according to random number table method.The control group was treated with choledochoscope hydroelectric lithotripsy treatment,the observation group was treated with choledochoscope and holmium laser lithotripsy treatment.Compared the surgical indexes,number of operations,total operation time,single cost and total hospitalization time,cost of the two groups,and the net rate of complications and stones.Result:The single treatment cost of the observation group was significantly higher than that of the control group(P<0.05),but the number of operations,total operation time,and average total hospital stay,total cost were significantly lower than those of the control group(P<0.05).Observation group abdominal discomfort,mild diarrhea,fever were lower than those of control group(P<0.05),and the net rate of stone extraction was slightly higher than that of control group,but the difference was not significant(P>0.05).Conclusion:Compared with electrohydraulic lithotripsy,choledochoscope combined with holmium laser lithotripsy has the advantages of flexible operation and less trauma,which can effectively improve the quality of lithotripsy,reduce postoperative complications,and reduce the economic pressure of patients.