内镜逆行胰胆管造影下取石术治疗胆囊切除术后胆总管结石患者的效果观察

Observation of endoscopic retrograde cholangiopancreatography in patients with choledocholithiasis after cholecystectomy

目的:分析内镜逆行胰胆管造影(ERCP)下取石术治疗胆囊切除术后胆总管结石患者的效果。方法:选取2019年1月—2021年1月张家港市第一人民医院收治的87例胆囊切除术后胆总管结石患者,随机分为对照组(n=40)与观察组(n=47)。对照组患者给予胆总管切开取石术,观察组患者给予ERCP下取石术。比较两组患者治疗效果、住院时间、切口疼痛时间、胃肠功能恢复正常时间、手术持续时间、切口长度、术中出血量、疼痛视觉模拟评分(VAS)、健康调查简表评分(SF-36)、并发症发生率。结果:观察组患者的住院时间、切口疼痛时间、胃肠功能恢复正常时间、手术持续时间、术中出血量、切口长度、切口疼痛程度优于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(4.25%)低于对照组(5.00%),但差异无统计学意义(P>0.05)。治疗前,两组患者的S F-36比较,差异无统计学意义(P>0.05);治疗后,两组患者的SF-36各项分数均增高,且观察组分数高于对照组,差异均有统计学意义(P<0.05)。观察组患者近期疗效以及远期疗效总有效率高于对照组,差异均有统计学意义(P<0.05)。结论:相较于胆总管切开取石术,给予胆囊切除术后胆总管结石患者ETCP下取石术治疗效果更加显著,能够全面促进患者疾病转归,提升患者生活质量,且安全性高,值得临床应用。

Objective To compare the long-term and short-term efficacy of endoscopic retrograde cholangiopancreatography(ERCP)for patients with choledocholithiasis after cholecystectomy.Methods From January 2019 to January 2021,87 patients with choledocholithiasis after chdecyst ectomy admitted to the First People’s Hospital of Zhangjiagang City were selected as the research objects,and they were randomly divided into the control group(n=40)and the observation group(n=47).The control group was given choledocholithotomy,and the observation group was given ERCP lithotomy.The treatment effect,hospital stay,incision pain time,gastrointestinal function recovery time,operation duration,incision length,intraoperative blood loss,pain visual analog scale(VAS),and health questionnaire score(SF-36)were compared between the two groups.and complication rates.Results The hospitalization time,incision pain time,gastrointestinal function recovery time,operation duration,intraoperative blood loss,incision length and incision pain degree of the observation group were better than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group(4.25%)was lower than that in the control group(5.00%),but there was no significant difference in the incidence of complications between the two groups(P>0.05).Before the intervention,there was no significant difference in SF-36 between the two groups(P>0.05);After the intervention,the SF-36 scores of the two groups were increased,and the quality of life scores in the observation group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The short-term efficacy and long-term efficacy of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with choledocholithotomy,ETCP lithotripsy is more effective in patients with choledocholithiasis after cholecystectomy,which can comprehensively promote the patient’s disease outcome,improve the quality of life of patients,and has high safety,which is worthy of clinical application.