利胆防石散治疗经可视胆道镜取石钳微创保胆取石术后患者的临床疗效

摘要

Objective:To observe the clinical effect of Chinese herbal medicine Lidan Fangshi Powder on cholelithiasis patients af -ter minimally invasive cholecystolithotomy by visual choledochoscopy lithotomy forceps .Methods:From June 2014 to June 2017, 90 patients with cholelithiasis were admitted to general surgery at Qinhuangdao First Hospital .The patients were randomly divided into observation group (N=45) and control group (N=45) according to the random table method.Ninety patients were treated under minimally invasive cholecystolithotomy preserving the gallbladder , and routine nursing and dietary guidance were given after operation in control group .Choledoxone was added in observation group .The gallbladder wall thickness , abdominal gallbladder volume, residual gallbladder volume after meal and recurrence of cholelithiasis before operation and three months after treatment were observed.Results:The total efficiency of observation group (97.78 ％) was higher than that of control group (88.89 ％) ( P<0.05) .There was no significant difference in the thickness , FV, RV and E of gallbladder wall between patients before treat-ment and control group ( P>0.05) .The comparison of biliary wall thickness , FV, RV and E between the two groups before and after treatment had an improvement (P<0.05).The observation group was superior to the control group in improving the biliary wall thickness, FV, RV and E (P<0.05).There was no significant difference in recurrence of cholelithiasis between the two groups ( P>0.05 ) .Conclusion:The treatment of cholelithiasis after minimally invasive cholecystolithotomy preserving the gall -bladder by visual choledochoscopy lithotomy forceps with Chinese herbal medicine can effectively improve the clinical effect , re-duce the thickness of gallbladder wall and enhance the contraction function of gallbladder .%目的:观察中药利胆防石散治疗经可视胆道镜取石钳微创保胆取石术后的胆囊结石患者的临床疗效.方法:选取2014年6月至2017年6月在秦皇岛市第一医院普外科收治的胆囊结石患者90例.按照随机表法,将患者随机分为观察组和对照组,每组45例.90例患者均在全麻下行经可视胆道镜取石钳微创保胆取石术,对照组患者术后给予常规护理和饮食指导,观察组患者在对照组的基础上添加利胆防石散.观察2组患者手术前以及治疗3个月后的胆囊壁厚度、空腹胆囊容积、餐后最小胆囊残余容积、胆囊收缩率以及胆囊结石复发情况.结果:观察组总有效率(97.78％)明显大于对照组总有效率(88.89％)(P<0.05);观察组治疗前与对照组治疗前患者胆囊壁厚度、FV、RV、E比较,差异无统计学意义(P>0.05);2组治疗前与治疗后患者胆囊壁厚度、FV、RV、E比较均有改善作用(P<0.05);观察组在改善患者胆囊壁厚度、FV、RV、E方面均优对照组(P<0.05);2组胆囊结石复发情况比较,差异无统计学意义(P>0.05).结论:经可视胆道镜取石钳微创保胆取石术后的胆囊结石患者结合中药利胆防石散治疗能有效地提高临床疗效,减少胆囊壁厚度,并增强胆囊的收缩功能.