目的：探讨硬质胆道镜和纤维胆道镜在肝内胆管结石中的疗效。方法：选择2014年1月-2015年1月在本院接受治疗的肝内胆管结石患者180例作为研究对象，采用随机数字表法分为研究组和对照组，分别应用硬质胆道镜和纤维胆道镜进行取石治疗，记录比较两组手术时间、术中出血量、术中输血量、一次取石率、探查成功率、肝内胆管巨大嵌顿取石率、肝脏边缘结石取出率、残石率、并发症发生率、再手术率及胆道炎复发率。结果：研究组手术时间、术中出血量、术中输血量、一次取石率、探查成功率及肝内胆管巨大嵌顿取石率均优于对照组，研究组肝脏边缘结石取出率低于对照组，以上比较差异均有统计学意义（P<0.05）；再手术率及胆道炎复发率比较两组残石率、并发症发生率、再手术率及胆道炎复发率比较，差异无统计学意义（P>0.05）。结论：硬质胆道镜和纤维胆道镜在治疗肝内胆管结石中各有优势，硬质胆道镜优势更为明显，临床可合理配合使用，提高取石成功率。%Objective:To investigate the curative effect of rigid choledochoscope and choledochofiberscope in intrahepatic biliary calculi.Method:180 patients who administered intrahepatic biliary calculi operation in our hospital from January 2014 to January 2015 were divided into the research group and the control group randomly.Rigid choledochoscope was applied to the research group and choledochofiberscope was applied to the control group.The operation time,intraoperative blood loss,intraoperative blood transfusion,once stone-free rate,exploration success rate,intrahepatic bile duct giant stone remove rate,liver edge stone eliminating rate,residual stone rate,complication rate,reoperation rate and recurrence rate of cholangitis were recorded and compared between the two groups.Result:The operation time,intraoperative blood loss,intraoperative blood transfusion,once stone-free rate,exploration success rate and intrahepatic bile duct giant stone remove rate of the research group were better than those of the control group. The liver edge stone eliminating rate of the research group was lower than that of the control group.The differences above were all statistically significant(P<0.05).The differences in the residual stone rate,complication rate,reoperation rate and cholangitis recurrence rate of the two groups were not statistically significant(P>0.05).Conclusion:Rigid choledochoscope and choledochofiberscope both have their own advantages in intrahepatic biliary calculi operation and the advantages of rigid choledochoscope are more obvious.They shall be used reasonably to improve the eliminating rate of biliary calculi.
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