目的:探究腹腔镜下左肝蒂阻断术治疗对肝内胆管结石疗效。方法:选取2020年5月至2022年9月我院收治的63例肝内胆管结石患者作为研究对象,按照随机数字表法分为观察组(n=32)和对照组(n=31)。对照组患者接受传统开腹手术治疗,观察组患者接...目的:探究腹腔镜下左肝蒂阻断术治疗对肝内胆管结石疗效。方法:选取2020年5月至2022年9月我院收治的63例肝内胆管结石患者作为研究对象,按照随机数字表法分为观察组(n=32)和对照组(n=31)。对照组患者接受传统开腹手术治疗,观察组患者接受腹腔镜左肝蒂阻断术治疗。比较两组患者术后恢复指标、肝功能指标水平、生活质量调查量表(Medical Outcomes Study 36-Item Short Form Health Survey,SF-36)评分、两组患者切口感染、胆漏及腹腔积液等不良反应发生情况。结果:术后观察组各恢复指标、丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate aminotransferase,AST)及总胆红素(Total bilirubin,TBIL)水平均低于对照组(P<0.05);治疗后观察组SF-36各方面评分均高于对照组(P<0.05);观察组不良反应总发生率明显低于对照组(χ^(2)=4.510,P=0.034)。结论:腹腔镜下左肝蒂阻断术治疗肝内胆管结石患者有利于促进其术后恢复,缩短病程,还可促进肝功能以及生活质量的改善,安全性高。展开更多
AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were...AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were included in this study.One week after single-blinded placebo run-in treatment,baseline nocturnal intragastric pH,bile reflux and nocturnal dyspeptic symptoms of eligible patients,including epigastric pain or discomfort,abdominal distention and belching, were investigated with questionnaires.Patients exhibiting nocturnal dyspeptic symptoms were randomly and double-blindly assigned to domperidone group or placebo group.Nocturnal intragastric pH and percentage of duodenogastric bile reflux time were determined after treatment. RESULTS:Of the 85 FD patients,2 females withoutnocturnal symptoms,who responded to placebo run-in treatment,were excluded from the study,30(36.1%) exhibited nocturnal dyspeptic symptoms with increased duodenogastric bile reflux time(intragastric bilirubin absorbance>0.14)and mean gastric pH(confirming the existence of bile reflux)(P=0.021,0.023) at night were included in the study.Of these 30 patients,21(70%)had overt nocturnal duodenogastric bile reflux,which was significantly higher than that of those without nocturnal symptoms(P=0.026).The 30 patients were allocated to domperidone group or placebo group(n=15).The nocturnal duodenogastric bile reflux and gastric pH were significantly decreased after domperidone treatment(P=0.015,0.021).The severity score of nocturnal dyspeptic symptoms was also significantly decreased after domperidone treatment (P=0.010,0.015,0.026),which was positively correlated with the reduced nocturnal bile reflux or gastric pH(r=0.736,0.784,0.753 or r=0.679,0.715,0.697, P=0.039,0.036,0.037 or P=0.043,0.039,0.040). CONCLUSION:A subgroup of Chinese FD patients show overt nocturnal dyspeptic symptoms,which may be correlated with the excessive nocturnal duodenogastric bile reflux.Domperidone therapy can alleviate these symptoms.展开更多
文摘目的:探究腹腔镜下左肝蒂阻断术治疗对肝内胆管结石疗效。方法:选取2020年5月至2022年9月我院收治的63例肝内胆管结石患者作为研究对象,按照随机数字表法分为观察组(n=32)和对照组(n=31)。对照组患者接受传统开腹手术治疗,观察组患者接受腹腔镜左肝蒂阻断术治疗。比较两组患者术后恢复指标、肝功能指标水平、生活质量调查量表(Medical Outcomes Study 36-Item Short Form Health Survey,SF-36)评分、两组患者切口感染、胆漏及腹腔积液等不良反应发生情况。结果:术后观察组各恢复指标、丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate aminotransferase,AST)及总胆红素(Total bilirubin,TBIL)水平均低于对照组(P<0.05);治疗后观察组SF-36各方面评分均高于对照组(P<0.05);观察组不良反应总发生率明显低于对照组(χ^(2)=4.510,P=0.034)。结论:腹腔镜下左肝蒂阻断术治疗肝内胆管结石患者有利于促进其术后恢复,缩短病程,还可促进肝功能以及生活质量的改善,安全性高。
基金Supported by Project of the National Key Technology R&D Program during the 11th Five-Year Plan Period,No.2007BAI04B01Shanghai Leading Academic Discipline Project,No.Y0205
文摘AIM:To investigate the incidence of nocturnal dyspeptic symptoms in patients with functional dyspepsia(FD) and whether prokinetic drugs can alleviate them. METHODS:Eighty-five consecutive Chinese patients with FD were included in this study.One week after single-blinded placebo run-in treatment,baseline nocturnal intragastric pH,bile reflux and nocturnal dyspeptic symptoms of eligible patients,including epigastric pain or discomfort,abdominal distention and belching, were investigated with questionnaires.Patients exhibiting nocturnal dyspeptic symptoms were randomly and double-blindly assigned to domperidone group or placebo group.Nocturnal intragastric pH and percentage of duodenogastric bile reflux time were determined after treatment. RESULTS:Of the 85 FD patients,2 females withoutnocturnal symptoms,who responded to placebo run-in treatment,were excluded from the study,30(36.1%) exhibited nocturnal dyspeptic symptoms with increased duodenogastric bile reflux time(intragastric bilirubin absorbance>0.14)and mean gastric pH(confirming the existence of bile reflux)(P=0.021,0.023) at night were included in the study.Of these 30 patients,21(70%)had overt nocturnal duodenogastric bile reflux,which was significantly higher than that of those without nocturnal symptoms(P=0.026).The 30 patients were allocated to domperidone group or placebo group(n=15).The nocturnal duodenogastric bile reflux and gastric pH were significantly decreased after domperidone treatment(P=0.015,0.021).The severity score of nocturnal dyspeptic symptoms was also significantly decreased after domperidone treatment (P=0.010,0.015,0.026),which was positively correlated with the reduced nocturnal bile reflux or gastric pH(r=0.736,0.784,0.753 or r=0.679,0.715,0.697, P=0.039,0.036,0.037 or P=0.043,0.039,0.040). CONCLUSION:A subgroup of Chinese FD patients show overt nocturnal dyspeptic symptoms,which may be correlated with the excessive nocturnal duodenogastric bile reflux.Domperidone therapy can alleviate these symptoms.
