经皮经肝十二指肠乳头肌扩张排石术治疗胆总管结石的疗效与安全性

Efficacy and Safety of Percutaneous Transhepatic Duodenal Papillary Muscle Expansion and Exclusion for Choledocholithiasis

目的观察经皮经肝十二指肠乳头肌扩张排石术治疗胆总管结石的疗效,评价其治疗安全性。方法对2017年12月—2019年11月前来该院治疗的胆总管结石患者进行筛选,从中便利选择96例作为该次研究的对象,分为对照组(内镜下乳头括约肌切开取石术)、试验组(经皮经肝十二指肠乳头肌扩张排石术)各48例。对比两组住院时间、术中出血量、肝功能实验室指标以及并发症发生率。结果试验组术中出血量(25.30±11.27)mL、住院时间(7.90±0.51)d,WBC(7.39±0.82)×10^(9)/L、TBIL(68.05±10.14)mmol/L、ALT(50.56±8.04)U/L、AST(43.78±10.36)U/L、血清淀粉酶(131.67±13.62)U/dl优于对照组的(54.32±10.49)mL,(13.30±0.47)d,(7.83±0.79)×10^(9)L、(92.43±11.03)mmol/L、(68.28±8.27)U/L、(54.09±10.21)U/L、(150.24±13.31)U/dl,差异有统计学意义(t=3.702,3.724,3.695,3.703,3.732,3.728,3.747,P<0.05),实验组发症发生率4.17%低于对照组20.83%,差异有统计学意义(χ^(2)=5.207,P<0.05)。结论对胆总管结石患者采用经皮经肝十二指肠乳头肌扩张排石术治疗效果显著,患者术后并发症发生率较低。

Objective To observe the efficacy of percutaneous transhepatic duodenal papillary muscle dilatation for treatment of choledocholithiasis and to evaluate its safety.Methods The patients with common bile duct stones who came to the hospital for treatment from December 2017 to November 2019 were screened.convenient select 96 cases were selected as the subjects of this study and divided into control group(endoscopic sphincterotomy);test group(percutaneous transhepatic duodenal papillary muscle dilatation);48 cases in each.The hospitalization time,intraoperative blood loss,liver function laboratory indicators,and the incidence of complications were compared between the two groups.Results In the experimental group,intraoperative blood loss(25.30±11.27)mL,hospitalization time(7.90±0.51)d,WBC(7.39±0.82)×109/L,TBIL(68.05±10.14)mmol/L,ALT(50.56±8.04)U/L,AST(43.78±10.36)U/L,serum amylase(131.67±13.62)U/dl are better than the control group(54.32±10.49)mL,(13.30±0.47)d,(7.83±0.79)×109/L,(92.43±11.03)mmol/L,(68.28±8.27)U/L,(54.09±10.21)U/L,(150.24±13.31)U/dl,the difference was statistically significant(t=3.702,3.724,3.695,3.703,3.732,3.728,3.747,P<0.05),the incidence of symptoms in the experimental group was 4.17%lower than that in the control group,20.83%,the difference was statistically significant(χ^(2)=5.207,P<0.05).Conclusion The treatment effect of percutaneous transhepatic duodenal papillary muscle expansion for patients with choledocholithiasis is significant,and the incidence of postoperative complications is low.