熊去氧胆酸片对胆囊合并胆总管结石术后老年患者肝功能及胆汁成分的影响

Effect of Ursodeoxycholic Acid Tablets on Liver Function and Bile Components in Elderly Patients with Gallbladder and Common Bile Duct Stones After Operation

目的探讨熊去氧胆酸片对胆囊合并胆总管结石术后老年患者肝功能及胆汁成分的影响。方法选取医院2021年2月至2023年2月收治的胆囊合并胆总管结石并行腹腔镜胆囊切除术联合消化内镜逆行性胰胆管造影术的老年(年龄不低于60岁)患者120例,按随机数字表法分为观察组和对照组,各60例。术后,对照组患者予常规治疗注射用头孢噻肟钠和异苷草酸镁注射液,观察组患者在对照组治疗基础上加用熊去氧胆酸片,两组患者均治疗3周。结果治疗后,两组患者的胆囊壁厚度均显著变小(P<0.05),胆囊收缩率均显著升高(P<0.05),且观察组均显著优于对照组(P<0.05);两组患者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶水平均显著降低(P<0.05),且观察组均显著低于对照组(P<0.05);两组患者的胆汁总胆固醇、总胆红素水平均显著降低(P<0.05),总胆汁酸水平均显著升高(P<0.05),且观察组均显著优于对照组(P<0.05)。术后2个月,观察组患者的腹胀、右上腹不适、胆绞痛等临床症状消失率均显著高于对照组(95.00%比61.67%,88.33%比68.33%,100.00%比76.67%,P<0.05)。术后1,6,12个月,观察组患者的结石复发率均显著低于对照组(0比1.67%,3.33%比8.33%,3.33%比18.33%,P<0.05)。结论熊去氧胆酸片可有效改善胆囊合并胆总管结石术后老年患者的肝功能及胆汁成分,减轻患者的临床症状,增强胆囊功能,减少结石复发。

Objective To investigate the effect of Ursodeoxycholic Acid Tablets on liver function and bile components in elderly patients with gallbladder and common bile duct stones after operation.Methods A total of 120 elderly patients(≤60 years)with gallbladder and common bile duct stones who underwent laparoscopic cholecystectomy combined with common bile duct exploration and lithotomy in the hospital from February 2021 to February 2023 were selected and divided into the observation group and the control group according to the random number table method,with 60 cases in each group.The patients in the control group were given routine treatment(Cefotaxime Sodium for Injection and Magnosium Isoglycyrrhizinate Injection)after operation,on this basis,the patients in the observation group were treated with Ursodeoxycholic Acid Tablets.Both groups were treated for three weeks.Results After treatment,the thickness of the gallbladder wall in the two groups significantly decreased(P<0.05),while the gallbladder contraction rate in the two groups significantly increased(P<0.05),and those in the observation group were significantly better than those in the control group(P<0.05).The levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the two groups significantly decreased(P<0.05),and those in the observation group were significantly lower than those in the control group(P<0.05).The levels of total cholesterol(TC)and total bilirubin(TBiL)in the two groups significantly decreased(P<0.05),while the level of the total bile acid(TBA)in the two groups significantly increased(P<0.05),and those in the observation group were significantly better than those in the control group(P<0.05).Two months after operation,the disappearance rates of clinical symptoms such as abdominal distension,discomfort in the upper right abdomen,and biliary colic in the observation group were significantly higher than those in the control group(95.00%vs.61.67%,88.33%vs.68.33%,100.00%vs.76.67%,P<0.05).The recurrence rates of stones in the observation group at 1,6,and 12 months after operation were significantly lower than those in the control group(0 vs.1.67%,3.33%vs.8.33%,3.33%vs.18.33%,P<0.05).Conclusion Ursodeoxycholic Acid Tablets can effectively improve liver function and bile components in elderly patients with gallbladder and common bile duct stones after operation,alleviate clinical symptoms,enhance gallbladder function,and reduce the recurrence rate of stones.