腹腔镜联合胆道镜和柴胡舒肝汤加减治疗胆管结石的临床效果观察

曾发庆

[摘要]目的 探討腹腔镜联合胆道镜和柴胡舒肝汤加减治疗胆管结石的临床效果。方法 选取我院2014年12月～2016年12月收治的120例胆管结石患者作为研究对象，按照治疗方式的不同分为研究组（50例）、对照组1（32例）、对照组2（38例）。对照组1采用腹腔镜联合胆道镜进行手术，对照组2采用传统的开腹手术治疗，研究组采用腹腔镜联合胆道镜和柴胡舒肝汤加减治疗，比较三组的临床疗效和术后恢复情况。结果 研究组和对照组1的手术时间短于对照组2，术中出血量少于对照组2，结石清除率高于对照组2，差异有统计学意义（P<0.05）。研究组的结石清除率显著高于对照组1，差异有统计学意义（P<0.05）。研究组和对照组1的胃肠功能恢复时间、住院时间短于对照组2，并发症发生率低于对照组2，差异有统计学意义（P<0.05）。研究组的并发症发生率低于对照组1，差异有统计学意义（P<0.05）。结论 腹腔镜联合胆道镜和柴胡舒肝汤加减治疗胆管结石效果显著，能够有效缩短手术时间及术后住院时间，减少术中出血量，提高结石清除率，有利于术后胃肠功能恢复，降低术后并发症发生率。

[关键词]胆管结石；腹腔镜联合胆道镜；柴胡舒肝汤加减治疗

[中图分类号] R575.6+2 [文献标识码] A [文章编号] 1674-4721（2017）04（b）-0152-03

Clinical effect observation of laparoscopy combined with choledochoscopy and Modified Chaihu Shugan Decoction in the treatment of bile duct stones

ZENG Fa-qing1，2

1.Traditional Chinese Medical Hospital of Taihe County in Jiangxi Province，Taihe 343700，China；2.Guanxi Health Center of Taihe County in Jiangxi Province，Taihe 343700，China

[Abstract]Objective To explore the clinical efficacy of laparoscopy combined with choledochoscopy and Modified Chaihu Shugan Decoction in the treatment of bile duct stones.Methods 120 patients with bile duct stones admitted to our hospital from December 2014 to December 2016 were selected as research subjects，all patients were divided into the study group （50 cases），the control group 1 （32 cases），the control group 2 （ 38 cases） according to the different treatment methods.The control group 1 was treated with laparoscopy combined with choledochoscopy surgery，the control group 2 was treated with traditional open surgery，the study group was treated with laparoscopy combined with choledochoscopy and Chaihu Shugan decoction.The clinical efficacy and postoperative recovery of the three groups were compared.Results The operation time of the study group and the control group 1 was shorter than that of the control group 2，and the blood loss of the study group and the control group 1 was less than that of the control group 2，and the stone clearance rate of the study group and the control group 1 was higher than that of the control group 2，with significant difference （P<0.05）.The stone clearance rate in the study group was significantly higher than that in the control group 1，with significant difference （P<0.05）.The gastrointestinal function recovery time，hospitalization time of the study group and the control group 1 was shorter than that the control group 2，the incidence rate of complications of the study group and the control group 1 was lower than that of the control group 2，with significant difference （P<0.05）.The incidence rate of complications in the study group was lower than that in the control group 1，with significant difference （P<0.05）.Conclusion Laparoscopy combined with choledochoscopy and ChaiHu ShuGan Decoction in the treatment of bile duct stones has significant effect，can effectively shorten the operation time and hospitalization time after operation，reduce the amount of bleeding，improve the stone clearance rate，is conducive to the recovery of gastrointestinal function after surgery，reduce the incidence of postoperative complications.

[Key words]Bile duct stone；Laparoscopy combined with choledochoscopy；Modified Chaihu ShuganDecoction for treatment

胆管结石是胆管系统常见的疾病，多见于女性，主要包括胆囊结石、胆管结石、肝内胆管结石[1]。近年来，随着人们生活习惯的改变，其发病率呈上升趨势。本病的发病原因主要与胆管感染、胆汁的淤积和胆固醇的代谢失调等多种原因相关，主要临床表现为右上腹胆绞痛。传统的治疗方法是开腹及胆总管切开取石治疗[2]。柴胡舒肝汤具有疏肝解郁、平抑肝阳的作用，能够维持肝脏疏肝泌胆的功能，促进胆汁的分泌[3]。本研究对我院收治的胆管结石患者进行胆道镜联合柴胡疏肝汤加减治疗，探讨其效果，现报道如下。

1资料与方法

1.1一般资料

选取我院2014年12月～2016年12月收治的120例胆管结石患者作为研究对象。入选标准：符合胆管结石诊断标准；患者病史、体征符合胆管结石症状并经B超、CT等影像学检查确诊；……