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腹腔镜下左肝蒂阻断术治疗对肝内胆管结石的疗效观察

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目的:探究腹腔镜下左肝蒂阻断术治疗对肝内胆管结石疗效.方法:选取 2020 年 5 月至 2022 年 9 月我院收治的 63 例肝内胆管结石患者作为研究对象,按照随机数字表法分为观察组(n=32)和对照组(n=31).对照组患者接受传统开腹手术治疗,观察组患者接受腹腔镜左肝蒂阻断术治疗.比较两组患者术后恢复指标、肝功能指标水平、生活质量调查量表(Medical Outcomes Study 36-Item Short Form Health Survey,SF-36)评分、两组患者切口感染、胆漏及腹腔积液等不良反应发生情况.结果:术后观察组各恢复指标、丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate aminotransferase,AST)及总胆红素(Total bilirubin,TBIL)水平均低于对照组(P<0.05);治疗后观察组 SF-36 各方面评分均高于对照组(P<0.05);观察组不良反应总发生率明显低于对照组(χ2=4.510,P=0.034).结论:腹腔镜下左肝蒂阻断术治疗肝内胆管结石患者有利于促进其术后恢复,缩短病程,还可促进肝功能以及生活质量的改善,安全性高.
Therapeutic effect of laparoscopic left hepatic pedicle occlusion on intrahepatic bile duct stones
Objective:To explore the therapeutic effect of laparoscopic left hepatic pedicle occlusion on intrahepatic bile duct stones.Methods:A total of 63 patients with intrahepatic bile duct stones who were admitted to the hospital from May 2020 to September 2022 were selected as the study subjects.According to the random number table method,the subjects were divided into an observation group(n=31)and a control group(n=31).Patients in the control group underwent traditional open surgery and those in the observation group underwent laparoscopic left hepatic pedicle occlusion.The two groups were compared in terms of postoperative recovery indicators,liver function indicators,Medical Outcomes Study 36-Item Short Form Health Survey(SF-36)scores,and incidence of adverse reactions such as incision infection,bile leakage and abdominal hydrops.Results:After operation,the levels of recovery indicators,alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)in the observation group were lower than those in the control group(P<0.05).After treatment,SF-36 scores of the observation group were higher than those of the control group(P<0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group(χ2=4.510,P=0.034).Conclusion:Applying laparoscopic left hepatic pedicle occlusion to treat patients with intrahepatic bile duct stones is beneficial for promoting postoperative recovery,shortening the course of disease,and improving liver function and quality of life,with high safety.

Intrahepatic bile duct stoneLaparoscopyLeft hepatic pedicle occlusionLiver functionPostoperative recovery

赵贞达、杨奀敏、郑睿琦

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上饶东信第五医院肝胆外科,江西 上饶 334000

肝内胆管结石 腹腔镜 左肝蒂阻断术 肝功能 术后恢复

2024

四川生理科学杂志
四川省生理科学会

四川生理科学杂志

影响因子:0.575
ISSN:1671-3885
年,卷(期):2024.46(6)