纤维胆道镜在肝胆管结石手术中的临床应用效果

Clinical utility of fiberoptic cholangioscopy for the management of hepatolithiasis

目的探讨纤维胆道镜在肝胆管结石手术中的临床应用效果。方法选取2018年2月至2020年2月于本院行肝胆管结石手术的88例患者作为研究对象,采用随机数字表法分为对照组与实验组,每组44例。对照组采用常规取石治疗,实验组在常规取石基础上采用纤维胆道镜治疗,比较两组疼痛程度、结石总清除率与结石复发率、手术时间、术中出血量、术中输血量、住院时间、并发症发生情况及临床疗效。结果术前,两组视觉模拟评分法(VAS)评分比较差异无统计学意义;实验组术后1、3 d VAS评分低于对照组,差异有统计学意义(P<0.05);实验组结石总清除率高于对照组,结石复发率低于对照组,差异有统计学意义(P<0.05);实验组手术时间长于对照组,术中出血量、术中输血量均少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);实验组并发症发生率低于对照组,差异有统计学意义(P<0.05);实验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论纤维胆道镜在肝胆管结石手术中的临床应用效果显著,能降低VAS评分、结石复发率、并发症发生率,减少术中出血量、术中输血量,提高结石总清除率与临床治疗总有效率,缩短住院时间。

Objective To investigate the clinical application of fiberoptic cholangioscopy in the operation of hepatolithiasis.Methods 88 patients who underwent surgery for hepatolithiasis at our hospital from February 2018 to February 2020 were selected as the research subjects,and they were divided into the control group and experimental group using the random number table method,with 44 cases in each group.The control group was treated with conventional stone removal,and the experimental group was treated with fiberoptic cholangioscopy on the basis of conventional stone removal,the degree of pain,total stone clearance rate and stone recurrence rate,operation time,intraoperative blood loss,intraoperative blood transfusion,length of hospitalization,complications and clinical efficacy were compared between the two groups.Results There was no significant difference in visual analogue scale(VAS)scores between the two groups preoperatively;VAS scores in the experimental group were lower than those in the control group at 1 and 3 d after surgery,and the difference was statistically significant(P<0.05);the total stone clearance rate in the experimental group was higher than that in the control group,and the stone recurrence rate was lower than that in the control group,and the differences were statistically significant(P<0.05);the operation time in the experimental group was longer than that in the control group,the amount of intraoperative blood loss and intraoperative blood transfusion were less than those in the control group,and the length of hospitalization was shorter than that in the control group,and the difference was statistically significant(P<0.05);the complication rate in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05);the total effective rate in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The clinical use of fiberoptic cholangioscopy in hepatolithiasis surgery has shown to be effective,reducing VAS scores,stone recurrence rate,complication rate,reducing intraoperative blood loss and intraoperative blood transfusion,increasing the total stone clearance rate with the overall clinical efficiency,and reducing the length of hospitalization.