腹腔镜联合胆道镜治疗高原肝包虫胆瘘临床效果的对照研究.pdf

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1、1238WestChinaMedicalJournal，Vo1．29，No．7Ju1．2014华西医学2014，29(7)论著腹腔镜联合胆道镜治疗高原肝包虫胆瘘临床效果的对照研究党宝宝，秦伟，董晋，褚筱玫【摘要】目的探讨腹腔镜联合胆道镜治疗高原肝包虫病胆瘘的临床效果。方法2012年1月一2013年6月选取100例肝包虫病患者，按人院先后顺序分为经腹腔镜联合胆道镜治疗组(两镜组)与单用腹腔镜手术治疗组(单镜组)，每组各50例。分析比较两组的临床效果。结果两镜组术中发现胆瘘186个，术后发生胆瘘5例

2、；单镜组术中发现胆瘘87个，术后发生胆瘘16例；两组术后胆瘘发生率差异有统计学意义(=7．294，P=-0．007)。两镜组术后无切口感染，单镜组切口感染5例。两镜组与单镜组术后拔管时间分别为(10．35士3．87)、(27．16士4．58)d，两组差异有统计学意义(t=12．538，P<0．001)。结论腹腔镜联合胆道镜治疗高原肝包虫胆瘘手术效果显著，优于单用腹腔镜手术，且安全有效，具有患者创伤小、康复快、住院时间短等优点。【关键词】腹腔镜；胆道镜；肝包虫病；胆瘘【文献标志码】ADOI：10．

3、7507／1002—0179．20140381ControlStudyofClinicalEfectoftheSurgerywithLaparoscopeandCholedochoscopeonPlateauHepaticHydatidBiloaryFistulasDANGBao—bao，QINWei,DONGJin，CHUXiao—mei．DepartmentofLaparoscopicSurgery,AfiliatedHospitalofQinghaiUniversity,Xining,Qi

4、nghai810001．R．ChinaCorrespondingauthor：DONGJin，E-mail：qhdongjin@163．com[Abstract]ObjectiveToexploretheeffectofthesurgerywithlaparoscopecombinedwithcholedochoscopeonplateauhepatichydatidbiliaryfistulas．MethodsAtotalof100patientswithliverhydatiddisease

5、diagnosedbetweenJanuary2012andJune2013weredividedintotwogroupsaccordingtotheadmittingtime：laparoscopecombinedwithcholedochoscopegroup(combinedgroup)andlaparoscopegroup，with50patientsineachgroup．Thetherapeuticresultsofthetwogroupswerecompared．ResultsA

6、totalof186biliaryfistulaswerefoundinthecombinedgroupduringtheoperation，andtherewere5patientswithbiliaryfistulasafterthesurgery；while87biliaryfistulaswerefoundinlaparoscopegroupduringtheoperationandtherewere16patientswithbiliaryfistulasafterthesurgery

7、．Thedifferenceintheoccurrencerateofbiliaryfistulasaftersurgerybetweenthetwogroupswassignificant0g=7．294，P=-0．007)．Noinfectionofincisionalwoundwasfoundincombinedgroupbut5infectionwasfoundinlaparoscopegroup．Thepostoperativeextubationtimeinthecombinedgr

8、oupandlaparoscopegroupwas(10．35士3．87)and(27．16士4．58)days，respectively，withasignificantdifference(t=12．538，P