摘要
目的观察纤维胆道镜联合钬激光治疗胆道结石对患者血清糖类抗原19-9(CA19-9)、癌胚抗原(CEA)表达的影响。方法选择蕉岭县人民医院普通外科2016年1月至2017年3月收治的93例胆管结石合并胆囊结石或肝胆管结石患者,根据患者意愿分为两组,对照组46例采用开放性取石术,观察组47例采用纤维胆道镜联合联合钬激光碎石术,两组患者均于入院第2天、术后1周抽取清晨空腹外周静脉血送检,采用化学发光法检测血清CA19-9、CEA水平。结果观察组患者术后1周的血清CA19-9、CEA水平分别为(16.71±2.53)、(2.55±0.37)μg/mL,均低于对照组的(27.32±4.18)、(3.62±0.53)μg/mL,且两组患者术后1周的血清CA19-9、CEA水平均低于术前,差异均有统计学意义(P<0.05);观察组患者术前CA19-9、CEA阳性率分别为63.83%、57.45%,术后1周分别为12.77%、10.64%,显著低于术前,也低于对照组术后1周的36.96%、30.43%,差异均有统计学意义(P<0.05)。结论纤维胆道镜联合钬激光治疗胆道结石能降低患者血清CA19-9、CEA表达,术后炎症反应轻,是微创有效的手术方法,具有推广价值。
Objective To observe the effect of fiber optic choledochoscope combined with holmium laser lithotripsy on the expression serum carbohydrate antigen 19-9（CA19-9） and carcinoembryonic antigen（CEA） in the treatment of bile duct stones.Methods A total of 93 cases of patients bile duct stones complicated with gallstones or hepatolithiasis,who admitted to Department of General Surgery of the People＇s Hospital of Jiaoling County from January 2016 to March 2017,were selected and divide into the control group and the observation group according to the patient＇s willingness for the treatment methods.The control group（n=46） was treated with open surgery for stone,and the observation group（n=47） was treated with fiber optic choledochoscope combined with holmium laser lithotripsy.The early morning fasting peripheral venous blood samples of the two groups were collected at second day after admission and one week after operation,and the serum levels of CA19-9 and CEA were detected by chemiluminescence method.Results One week after the operation,the serum levels of CA19-9 and CEA in the observation group were respectively（16.71±2.53） μg/mL and（2.55±0.37） μg/mL,which were significantly lower than（27.32±4.18） μg/mL and（3.62±0.53） μg/mL in the control group,and they also were significantly lower those before the operation（P0.05）.The positive rate of CA19-9 and CEA before the operation in the observation group were respectively 63.83% and57.45%,which not only were significantly higher than 12.77% and 10.64% one week after the operation,but also were significantly higher than 36.96% and 30.43% one week after the operation in the control group（P0.05）.Conclusion Fiber optic choledochoscope combined with holmium laser lithotripsy can decrease the expression of serum CA19-9 and CEA,and the postoperative inflammatory reaction is mild,which is a minimally invasive and effective surgical method and has the promotion value.
出处
《海南医学》
CAS
2017年第24期4004-4006,共3页
Hainan Medical Journal
基金
广东省梅州市科技计划项目(编号:2016B129)
关键词
纤维胆道镜
钬激光
胆道结石
糖类抗原19-9
癌胚抗原
影响
Fiber optic choledochoscope
Holmium laser
Biliary calculi
Carbohydrate antigen 19-9（CA19-9）
Carcinoembryonic antigen （CEA）
Effect
