陈 成



经内镜与开腹手术治疗胆总管结石的对比分析

陈 成

【摘要】目的 分析对比经内镜与开腹手术治疗胆总管结石的效果。方法 研究时间为2015年1～11月，纳入胆总管结石共43例，抽签分组。20例采用开腹手术，入对照组；23例采用经内镜手术，入观察组。比较组间疗效。结果 两组中观察组一次成功率高，差异有统计学意义（P ＜0.05）。结论 经内镜治疗胆总管结石效果较佳。

【关键词】胆总管结石；开腹手术；经内镜治疗

Objective Effect of endoscopic operation and laparotomy operation in treatment of choledocholithiasis are to be comparatively studied. Methods Chose 43 patients of choledocholithiasis who were treated in our hospital from January to November 2015 and separated them into two groups by drawing lottery. 20 patients in control group were given laparotomy operation，while another 23 patients in study group were given endoscopic operation，and then compared patients'treatment effect between two groups. Results Patients'operation one-time pass rate in study groupwas much higher than that in control group，there was a differential between two groups and such a differential had statistic value （P＜ 0.05）. Conclusion Endoscopic operation is much more effective in treatment of choledocholithiasis.

【Key words】 Choledocholithiasis，Laparotomy operation，Endoscopic operation

胆总管结石为常见外科病，按不同性质及结石来源可分继发性和原发性，继发性为胆囊切除术由胆囊掉入或胆囊排入胆总管引起，原发性为胆总管内原发引起［1］。本文研究时间2015年1～11月，纳入胆总管结石共43例，对比分析经内镜与开腹手术治疗胆总管结石的效果，具体见下。

1　资料和方法

1.1一般资料

2015年1～11月纳入胆总管结石共43例，抽签分组。20例采用开腹手术，入对照组，多发性8例，12例单发性，复发性或术后残留结石11例，9例原发性结石；平均年龄（49.65±3.46）岁，最大者是78岁，最小者是40岁，女患者有9例，11例男患者。23例采用经内镜手术，入观察组，多发性8例，15例单发性，复发性或术后残留结石13例，10例原发性结石；平均年龄（49.61±3.45）岁，最大者是79岁，最小者是40岁，女患者有10例，13例男患者。组间有均衡性，差异无统计学意义（P＞0.05）。

1.2方法

1.2.1对照组 给予开腹胆囊切除术、胆总管切开取石术及T管引流，或实施胆总管切开取石和T管引流。手术后给予补液、抗感染、营养支持及利胆等，观察切口愈合和胆汁引流情况，4周后给予胆道镜和胆道造影检查，拔除T管。……