摘要
目的:评价改良胆道冲洗液对经T管窦道纤维胆道镜胆道取石的临床影响。方法:收治的肝内外胆道结石、胆总管探查T管引流术后胆道残余结石患者80例,以随机数表随机分为传统组30例及改良组50例,两组均在拔出T管后经T管窦道行纤维胆道镜检查并取出残石;传统组采用传统冲洗液(生理盐水)、改良组采用改良冲洗液(生理盐水加庆大霉素、利多卡因、地塞米松);比较两组的取石效果、菌落计数及并发症的发生情况并进行统计学分析。结果:80例病人取净结石73例(91%),其中传统组残石取净率为83%(25/30),改良组残石取净率为96%(48/50);取石后菌血症发生率、胆汁内菌落计数以及发热、术中和术后腹痛、腹泻等发生率,改良组均低于传统组。结论:胆道冲洗液的改进可以使冲洗液成为纤维胆道镜取石的重要辅助手段,提高残石取净率,减少取石术后并发症的发生。
Objective:To evaluate the value of the improved douche in the CHF stone extraction for residual hepatolithiasis through the T tube fistula.Methods:80 cases with residual hepatolithiasis were randomly divided into the improved douche group of 50 cases and the traditional douche group of 30 cases.During the operation through the T tube fistula in our department,the improved group were treated by improved douche composed of physiological saline,gentamicin,lidocaine, dexamethasone and the traditional group only were treated by physiological saline.The colony count,the incidence of complications and the curative effects of the two groups were analyzed.Results:73 cases were successful in the 80 cases(91%).The success rate was 96%(48/50) in the improved group and 83%(25/30) in the traditional one.The improved group had a lower level of the colony count and the incidence of complications than the traditional one Conclusions:The improved douche can play a effective role in the treatment of CHF stone extraction for residual hepatolithiasis through the T tube. It can not only increase the success rate of operation,but also decrease the incidence of its complications.
