摘要
目的比较精准肝切除术(precise hepatectomy,PH)与非规则性肝切除术(irregular hepatectomy,IH)治疗肝内胆管结石(intrahepatic bile duct stone,IBDS)的疗效。方法选择2014年6月至2015年12月在成都医学院第一附属医院肝胆外科治疗的IBDS患者86例,依据计算机生成随机数字分为PH组和IH组,各43例。记录两组术中出血量、手术时间、当日引流量、治疗费用、术后住院时间,检测术前及术后1周两组肝功能指标变化,评价临床疗效,计算结石残留率及术后并发症发生率。结果 PH组术中出血量、当日引流量、术后住院时间及治疗费用均低于IH组,手术时间长于IH组,两组比较,差异有统计学意义(P<0.05)。术前及术后1周,两组ALT、ALB、APTT、TBIL、AST水平比较,差异均无统计学意义(P>0.05)。PH组优良率(95.35%)高于IH组(74.42%)(P<0.05)。PH组术后并发症发生率(18.60%)低于IH组(46.51%)(P<0.05)。PH组结石残留率(6.98%)也低于IH组(25.58%)(P<0.05)。结论 PH治疗IBDS可减少手术创伤,降低术后并发症发生率和结石残留率,有利于患者康复。
Objective To compare the efficacy of precise hepatectomy（PH）and irregular hepatectomy（IH）in treating intrahepatic bile duct stone（IBDS）.Methods 86 cases of IBDS patients treated in the department of hepatobiliary surgery of The First Affiliated Hospital of Chengdu Medical College between June of 2014 and December of 2015 were selected and divided into PH group and IH group according to the random numbers generated by computer,and each group consisted of 43 cases.The indicators including intraoperative blood loss,time of operation,drainage volume of operation day,treatment cost,postoperative hospital stay,changes of liver function indexes before operation and one week after operation,residual stone rate and postoperative complications were observed and analyzed. Results The intraoperative blood loss,drainage volume of operation day,postoperative hospital stay and treatment cost were was significantly lower in PH group than in IH group（P〈0.05）,but the operation time of PH group was significantly longer than that of IH group（P〈0.05）.There were no significant differences in ALT,ALB,APTT,TBIL and AST between the two groups before the operation and one week after the respectively operation（P〉0.05）.The excellent rate of PH group（95.35%）was significantly higher than that of IH group（74.42%）（P〈0.05）.The postoperative complication rate of PH group（18.60%）was significantly lower than that of IH group（46.51%）（P〈0.05）.The stone residue rate of PH group（6.98%）was significantly lower than that of IH group（25.58%）（P〈0.05）.Conclusion PH treatment has less operative wound and lower rate of postoperative complication and residual stone in the treatment of IBDS,which is conductive to the recovery of patients with IBDS.
出处
《成都医学院学报》
CAS
2016年第5期565-568,共4页
Journal of Chengdu Medical College
基金
四川省卫生厅科研项目(No:130389)
关键词
精准肝切除术
非规则性肝切除术
肝内胆管结石
比较
Precise Hepatectomy
Irregular Hepatectomy
Intrahepatic Bile Duct Stone
Comparison
