消炎利胆片联合双镜微创手术治疗肝内胆管结石疗效观察

Observation on Clinical Effects of Xiaoyan Lidan Tablets Combined with Double-mirror Minimally Invasive Surgery in Treating Hepatolithiasis

目的:观察消炎利胆片联合双镜微创手术治疗肝内胆管结石的临床疗效。方法:将肝内胆管结石患者60例采用随机数字表法分为研究组和对照组各30例,两组均行双镜(胆道镜和腹腔镜)联合微创手术治疗,术后对照组接受常规治疗,研究组在对照组治疗的基础上口服消炎利胆片,服药12个月。对比术前及术后3个月两组患者肝功能指标:血清谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartate transaminase,AST)、总胆红素(total bilirubin,TBIL)水平;比较术后3天及术后3个月两组患者结石残余率及术后3个月内并发症发生情况、术后1年内复发情况。结果:术后3个月两组患者血清ALT、AST、TBIL水平均低于术前(P<0.05),研究组低于对照组(P<0.05);术后3天两组患者结石残余率比较差异不显著(P>0.05),术后3个月研究组结石残余率低于对照组(P<0.05);术后3个月内两组患者血淀粉酶(amylase,AMY)升高、胆道动力障碍(post-chol ecystectomy blocked dynamia,PCBD)等并发症发生率及总发生率比较差异不显著(P>0.05);术后1年内复发率研究组为3.33%(1/30),对照组为23.33%(7/30),研究组低于对照组(P<0.05)。结论:消炎利胆片联合双镜微创手术可改善肝内胆管结石患者肝功能,利于术后结石排出,能有效减少术后复发情况。

Objective: To observe clinical effects of Xiaoyan Lidan tablets combined with double-mirror minimally invasive surgery in the treatment of hepatolithiasis. Methods: Sixty patients were allocated to the study group and the control group according to random number table method, both groups were treated by minimally invasive surgery of choledochoscopy and laparoscopy, after the surgery the control group accepted conventional therapy, and the study group took Xiaoyan Lidan tablets based on the therapy the control group accepted, for 12 months. To compare the indexes of liver function(the levels of ALT, AST and TBIL) in both groups before the surgery and three months after the surgery;To compare residual rates of both groups three days and three months after the surgery;to compare the incidence of the complications within three months after the surgery, the recurrence conditions within one year after the surgery. Results: The levels of ALT, AST and TBIL of the patients in both groups three months were lower than these before the surgery(P<0.05), the study group was lower than the control group(P <0.05);the difference wasn’t significant in residual stone rates between both groups three days after the surgery(P>0.05), residual stone rate of the study group was lower than that of the control group three months after the surgery(P <0.05);AMY rose in the patients of both groups within three months after the surgery, while the difference was insignificant in the incidence and total incidence of the complications such as PCBD(P>0.05);the recurrence rate within one year after the surgery in the study group was 3.33%(1/30), lower than 23.33%(7/30) of the control group(P <0.05). Conclusion: Xiaoyan Lidan tablets combined with double-mirror minimally invasive surgery could improve liver function, help stone discharge after the surgery, and effectively reduce the recurrence after the surgery.