中药防石散对微创保胆术后胆囊排空功能调控的临床研究

摘要

[Objectives] To investigate the regulation effect of Fangshi power after endoscopic invasive choleeystolithotomy with gallbladder preserved. Evaluation the clinical value on promoting recovery of the gallbladder. [Methods] Randomly selected 168 cases of cholecystolithiasis were treated by laparoscope and choledochoscope preservation of gallbladder, the gallbladder motility was examined by B-mode ultrasound. Based on the average value of Rf +2sd (32.3%) of the control group, selected 90 cases of cholecystolilhiasis with dysfunction of gallbladder motility were given Fangshi Powder 7 days after surgery for 3 months. Gallbladder volume was measured by B urtrasounography and calculated by ellipse formula during different time phases after surgery for 15, 30, 60 and 90 days. [Results] All the operation of minimally invasive gallbladder-protected lithotomy for 168 patients were successful without serious complications. All the patients were recovered and discharged from hospital from 3 to 5 days. The fasting gallbladder volume and minimal residual postprandial gallbladder volume after surgery for 15days was higher than before surgery, gallbladder emptying rate was lower than before surgery. No significant difference was found between the two groups. The index was close between the two group 30 days after surgery and before surgery. The fasting gallbladder volume and minimal residual postprandial gallbladder volume after surgery for 60 and 90 days were lower that of before surgery, gallbladder emptying rate was higher than that of before surgery. Significant difference were found between the two groups (P<0.05). [ Conclusion] Application of Fanshi power for patients received minimally invasive gallbladder -protected lithotomy can enhance the contraction function of gallbladder and prevent the relapse of cholelithiasis.%目的 探讨内镜微创保胆取石术后中药防石散对胆囊动力学的调控作用,评价其在内镜保胆术促进胆囊恢复的临床应用价值.方法 随机选择168例通过腹腔镜联合胆道镜保胆术患者,B超观察胆囊运动功能,以对照组平均Rf+2sd值(32.3％)为界限,选取术前胆囊运动动力紊乱者90例配合术后7d服用防石散,1个月为1疗程,共服3个疗程.术后第15、30、60和90天超声测量多个时相胆囊长径、横径、前后径,用椭圆形体积公式计算胆囊容积.结果 168例内镜保胆均获成功,3～5d痊愈出院.术后15d患者胆囊排空功能与术前比较,空腹胆囊容积、餐后最小胆囊残余容积均高于术前,胆囊排空率低于术前,两组之间差异无显著性,术后30d与术前接近,术后60 d空腹胆囊容积、餐后最小胆囊残余容积均低于术前、胆囊排空率高于术前,差异有显著性(P＜0.05),90d空腹胆囊容积、餐后最小胆囊残余客积均低于术前、胆囊排空率高于术前,差异均有显著性(P＜0.01).结论 保胆取石术后结合防石散治疗,能有效调控胆囊排空功能,以预防结石复发.