输尿管镜治疗肝内胆管结石的临床应用

Clinical applications of ureteroscope in treatment of intrahepatic bile duct calculus

摘要:

目的 探讨输尿管镜在肝内胆管结石治疗中的临床应用。方法 选择2010年1月~2013年6月在该院治疗的肝内胆管结石患者64例，采用输尿管镜气压弹道碎石技术治疗，并与普通胆道镜碎石技术治疗的53例患者的临床效果进行对比。结果 采用输尿管镜气压弹道碎石技术治疗的患者，其手术出血量、肠功能恢复时间等指标均低于普通胆道镜碎石技术所治疗的患者（P <0.05），T管拔除时间高于普通胆道镜碎石技术（P <0.05）。采用输尿管镜气压弹道碎石技术治疗的患者，净石率高于普通胆道镜碎石技术（P <0.05），并发症发生率、残石率、再手术率均低于普通胆道镜碎石技术（P <0.05）。结论 利用输尿管镜治疗肝内胆管结石患者，可以取得较好的治疗效果，值得临床推广。

Abstract:

【Objective】 To investigate the clinical value of ureteroscope in treating intrahepatic bile duct calculus. 【Methods】 64 patients with intrahepatic bile duct calculus in our hospital at January 2010～June 2013 were treated with ureteroscopic pneumatic ballistic lithotripsy, and 53 patients treated with choledochoscopic lithotripsy were compared. 【Results】 The indices of patients who were treated with ureteroscopic pneumatic ballistic lithotripsy, such as bleeding volume in operation and recovery time of intestinal function were lower than those who were treated with choledochoscopic lithotripsy (P＜0.05), however, the removal time of T tube showed the opposite trend (P＜0.05). The effects of patients who were treated with ureteroscopic pneumatic ballistic lithotripsy, such as the rate of calculi clearance were higher than those who were treated with choledochoscopic lithotripsy (P＜0.05), and incidence of complications, the rate of residual calculus and the rate of reoperation showed the opposite trend (P＜0.05). 【Conclusion】 Ureteroscope is recommended to be applied in the treatment of intrahepatic bile duct calculus because of its good effects.