超声引导下经皮肝穿刺软、硬镜联合治疗肝内外胆管结石的应用效果

Application Effect of Ultrasound-Guided Percutaneous Liver Puncture Combined with Rigid and Flexible Endoscopy for Treatment of Intrahepatic and Extrahepatic Bile Stones

目的:探讨超声引导下经皮肝穿刺软、硬镜联合治疗肝内外胆管结石的应用效果。方法:选取2020年9月—2021年8月惠州市第六人民医院收治的肝内外胆管结石患者20例为观察对象,根据随机数字表法分为对照组与观察组,各10例。观察组给予超声引导下经皮肝穿刺软、硬镜联合治疗,对照组给予经皮肝穿刺软硬质胆道镜治疗。比较两组患者手术效果、结石清除效果、疼痛评分(视觉模拟疼痛评分)。结果:观察组手术时间长于对照组,术后肛门排气时间、术后住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组结石清除率高于对照组,结石复发率低于对照组,差异有统计学意义(P=0.000);术后1、3个月,观察组疼痛评分低于对照组,差异有统计学意义(P=0.000)。结论:肝内外胆管结石患者采取超声引导下经皮肝穿刺软、硬镜联合治疗,可合理提高手术质量,减少出血量,提高结石清除率,降低结石复发率,术后疼痛轻。

Objective:To investigate the application effect of ultrasound-guided percutaneous liver puncture combined with rigid and flexible endoscopy in the treatment of intrahepatic and extrahepatic bile stones.Methods:Twenty patients with intrahepatic and extrahepatic bile stones admitted to Huizhou Sixth People's Hospital from September 2020 to August 2021 were selected as the observation objects.According to random number table method,they were divided into control group and observation group,with 10 cases in each group.The observation group underwent ultrasound-guided percutaneous liver puncture combined with rigid and flexible endoscopy.The control group underwent percutaneous liver puncture combined with rigid and flexible choledochoscopy.The surgical effect,stone clearance effect and pain score(visual analogue scale score)were compared between the two groups.Results:The operation time in the observation group was longer than that in the control group.The postoperative anal exhaust time and postoperative hospitalization time in the observation group were shorter than those in the control group.Intraoperative blood loss in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The stone clearance rate in the observation group was higher than that in the control group,and the stone recurrence rate in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.000).At 1 and 3 months after surgery,the pain score in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.000).Conclusion:Ultrasound-guided percutaneous liver puncture combined with rigid and flexible endoscopy for patients with intrahepatic and extrahepatic bile stones can reasonably improve the quality of surgery,reduce the blood loss,increase the stone clearance rate,reduce the recurrence rate of stones,and cause mild postoperative pain.