胆石症患者的个体化方案治疗

摘要

Objective To retrospective analyze the effect of individualization treatment of calculus of cholelithiasis pa-tients. Methods 3176 patients with different kind of cholelithiasis were treated in our hospital during Aug 2006 to Jan,2015, including 2987 gallstone patients and 189 calculus of bile duct patients.Periodic review of B ultrasound and follow-up was taken after the surgery for 9 years,recording and analyzing intraoperative and postoperative complications,symptoms,residual stones and stone recurrence rate and other,and to evaluate the therapeutic effect. Results Surgeries of all the patients were per-formed successfully.Postoperative follow-up indicated that symptoms were relieved.The operative duration of gallstone patients was (35.7 ±14.5)min,and the average hospitalization time was (3.5 ±2.5)days.The operative duration of calculus of bile duct patients was (70.3 ±31.5)min,and the average hospitalization time was (9.5 ±4.7)days.And the calculus residual rate and recurrence rate of gallstone patients was 0.1% and 8.1% individually.The calculus residual rate and recurrence rate of calculus of bile duct patients was 3.7% and 5.5%. Conclusion Conditions of calculus of cholelithiasis patients are compli-cated,especially calculus of intrahepatic duct patient.It is necessary to take individual treatment schedule for them.%目的：回顾分析我院胆石症患者个体化治疗方案的效果。方法2006年8月—2015年1月，我院治疗不同类型胆石症患者3176例，其中胆囊结石2987例，其他类型胆管结石患者189例，定期复查 B 超等影像检查并最长随访9年，从并发症和术后主观症状、残石率和结石复发率等情况，了解治疗效果。结果全组患者均手术成功，大部分自觉症状明显好转，胆囊结石患者平均手术时间（35.7±14.5）分钟，平均住院时间（3.5±2.5）天；胆管结石平均手术时间（70.3±31.5）分钟，平均住院时间（9.5±4.7）天。胆囊结石残留率0.1％，保胆术式结石复发率8.1％；胆管结石残留率3.7％和复发率5.5％。结论胆石症患者病情繁杂多样，尤其是肝内胆管结石，治疗需要个体化。