ERCP与腹腔镜胆总管切开取石治疗老年胆总管结石患者的效果比较
Comparison of the effects of ERCP and laparoscopic choledocholithotomy in the treatment of elderly patients with bile duct stones
侯龙辉 1朱海林 1马晓阳1
作者信息
- 1. 宝鸡市中心医院,陕西 宝鸡,721000
- 折叠
摘要
目的 比较经内镜逆行胰胆管造影术(ERCP)与腹腔镜胆总管切开取石治疗老年胆管结石患者的效果.方法 选择2017年3月至2022年6月在本院就诊的120例老年胆总管结石患者作为研究对象,按照手术方式将其分为观察组和对照组,各60例.观察组给予ERCP术治疗,对照组接受腹腔镜胆总管切开取石术治疗.比较两组的治疗效果.结果 观察组的并发症总发生率低于对照组(P＜0.05).观察组的手术时间、引流时间和住院时间短于对照组,术中出血量少于对照组(P＜0.05).术后,观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、皮质醇(COR)、去甲肾上腺素(NE)及促肾上腺皮质激素(ACTH)水平低于对照组(P＜0.05).结论 ERCP可明显改善老年胆管结石患者的肝功能、炎性因子、应激指标,具有较高的应用价值.
Abstract
Objective To compare the effects of endoscopic retrograde cholangiopancreatography(ERCP)and laparoscopic choledocholithotomy in the treatment of elderly patients with bile duct stones.Methods A total of 120 elderly patients with bile duct stones who were treated in our hospital from March 2017 to June 2022 were selected as the study objects.The patients were divided into observation group and control group according to the operation method,with 60 cases in each group.The observation group was treated with ERCP,and the control group received laparoscopic choledocholithotomy treatment.The therapeutic effects of the two groups were compared.Results The total incidence of complications in the observation group was lower than that in the control group(P＜0.05).The operation time,drainage time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P＜0.05).After operation,the levels of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6),total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),cortisol(COR),norepinephrine(NE)and adrenocorticotropic hormone(ACTH)in the observation group were lower than those in the control group(P＜0.05).Conclusion ERCP can significantly improve the liver function,inflammatory factors and stress indicators of elderly patients with bile duct stones,and has high application value.
关键词
腹腔镜胆总管切开取石/经内镜逆行胰胆管造影术/老年患者/胆总管结石Key words
laparoscopic choledocholithotomy/endoscopic retrograde cholangiopancretography/elderly patient/bile duct stone引用本文复制引用
基金项目
宝鸡市卫生健康委科研项目(2020-003)
出版年
2024
NETL
NSTL
万方数据