摘要
目的探讨柴胡排石汤胆管灌注联合十二指肠镜治疗困难胆总管结石的临床有效性及安全性。方法纳入2018年8月至2020年1月本院困难胆总管结石患者60例,采用前瞻性随机对照研究分为试验组和对照组各30例。试验组行十二指肠镜下鼻胆管引流术,经鼻胆管注入20~50 mL柴胡排石汤,夹闭鼻胆管末端2 h后通畅引流,上述方法每日3次,共10 d。对照组以相同容积的生理盐水以同样的方法注入。观察胆总管结石溶解、裂解与取石效果等情况,在第10天复查B超及取石治疗。结果试验组结石溶解、裂解率明显高于对照组(P<0.01),手术时间和术中出血量均低于对照组(P<0.01),结石一次取尽率高于对照组(P<0.05)。与对照组相比,试验组未增加术后并发症的发生率。结论柴胡排石汤胆管灌注联合十二指肠镜治疗困难胆总管结石安全、有效,为中西医结合治疗困难胆总管结石提供了新的依据。
Objective To investigate the clinical efficacy and safety of Chaihu Paishi Decoction through bile duct perfusion combined with duodenoscopy in the treatment of difficult choledocholithiasis.Methods A prospective randomized controlled study was carried out on the patients with difficult choledocholithiasis admitted in our department from August 2018 to January 2020.They were randomly divided into an experimental group and a control group,with 30 cases in each group.In the experimental group,20~50 mL Chaihu Paishi Decoction was injected into the nasobiliary duct under the guidance of duodenoscopy,and the end of the duct was clamped for 2 h.The above treatment was given 3 times per day,for 10 d.The control group was treated with normal saline in the same way.The stone dissolution,lysis rate and stone remove were observed to evaluate the efficiency.On the 10 th day,ultrasound examination was performed,and duodenoscopy was carried out.Results The stone dissolution and lysis rates were significantly higher in the experimental group than those in the control group(P<0.01).The experimental group had obviously shorter operation time and less blood loss(P<0.01)and notably higher one-shot stone removal rate(P<0.05)when compared with the control group.The experimental group did not differ from the other group in the incidence of postoperative acute pancreatitis.Conclusion Chaihu Paishi Decoction through bile duct perfusion combined with duodenoscopy is safe and effective in the treatment of difficult common bile duct stones,which provides a new basis for the treatment in combination with traditional Chinese and Western medicine.
作者
唐腾骞
杨智清
刘丹青
欧霞
甘浪
张雷达
TANG Tengqian;YANG Zhiqing;LIU Danqing;OU Xia;GAN Lang;ZHANG Leida(Department of Hepatobiliary Surgery,First Affiliated Hospital,Army Medical University(Third MilitaryMedical University),Chongqing,400038,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2021年第3期234-238,共5页
Journal of Third Military Medical University
基金
重庆市卫生计生委中医药科技项目(ZY201802095)。
关键词
柴胡排石汤
十二指肠镜
困难胆总管结石
Chaihu Paishi Decoction
duodenoscopy
difficult choledocholithiasis
