胆宁片预防腹腔镜联合胆道镜保胆取石术后结石复发的效果

Effect of Danning tablet in prevention of stone recurrence after minimally invasive gallbladder-preserving lithotomy through laparoscopy combined with choledochoscopy

目的探究胆宁片预防腹腔镜联合胆道镜微创保胆取石术(LRCL)术后患者结石复发的效果。方法选取2018年2月至2020年2月上犹县人民医院收治的72例胆囊结石患者,按照随机数字表分为观察组和对照组,每组36例。两组患者均给予LRCL治疗,对照组给予常规护理和安慰剂,观察组在对照组基础上增加口服胆宁片,持续3个月。对两组患者进行12个月的随访。比较两组患者术前、术后6个月、术后12个月胆囊壁厚度、胆囊收缩率、血浆胆囊收缩素(CKK)水平;比较两组患者胆囊结石复发率及不良反应。结果与术前比较,术后6个月、12个月两组患者胆囊壁厚度降低,胆囊收缩率、血浆CKK水平及消化病生存质量指数(GIQLI)评分升高(P<0.01),观察组患者在术后6个月、12个月胆囊壁厚度低于对照组,胆囊收缩率、血浆CKK水平及GIQLI评分高于对照组(P<0.001);观察组患者结石复发率低于对照组(2.78%vs 22.22%),不良反应总发生率低于对照组(13.89%vs 36.11%),差异有统计学意义(P<0.05)。结论腹腔镜联合胆道镜保胆取石术后使用胆宁片可有效恢复胆囊功能,降低胆囊结石复发率及不良反应,提高生活质量,值得临床推广应用。

Objective To investigate the effect of Danning tablets in preventing stone recurrence after minimally invasive gallbladder-preserving lithotomy through laparoscopy combined with choledochoscopy(LRCL).Methods 72 patients with gallstones admitted to People’s Hospital of Shangyou County from February 2018 to February 2020 were selected and divided into study group and control group according to random number table,with 36 cases in each group.Both groups were treated with LRCL.The control group were given conventional care and placebo,and the study group were given Danning tablets on the basis of the control group for 3 months.Both groups were followed up for 12 months.The gallbladder wall thicknesses,gallbladder contraction rates,and plasma cholecystokinin(CKK)levels were compared between the two groups before surgery,at 6 months and 12 months after operation,and the recurrence rate of gallbladder stone and adverse reactions were compared.Results Compared to the conditions before surgery,the gallbladder wall thicknesses decreased in both groups at 6 months and 12 months after operation,and the gallbladder contraction rates,plasma CKK levels,and Gastrointestinal Quality of Life Index(GIQLI)scores increased(P<0.01).At 6 months and 12 months after surgery,the gallbladder wall thickness in the study group was lower than that in the control group,and the gallbladder contraction rate,plasma CKK level and GIQLI score were higher than those in the control group(P<0.001).The recurrence rate of stone in the study group was lower than that in the control group(2.78%vs 22.22%),and the total incidence of adverse reactions in the study group was lower than that in the control group(13.89%vs 36.11%),and differences were all statistically significant(P<0.05).Conclusion After minimally invasive gallbladder-preserving lithotomy through laparoscopy combined with choledochoscopy,Danning tablets can effectively restore gallbladder function,reduce the recurrence rate of gallbladder stones and adverse reactions,and improve the quality of life,which is worthy of promotion and application in clinical practices.