【摘要】 目的探讨腹腔镜联合十二指肠镜治疗胆囊结石合并胆总管结石的临床价值。方法将2017年4月至2019年6月收治的78例胆囊结石合并胆总管结石患者随机分为试验组和对照组,比较其临床指标和并发症。结果试验组手术时间高于对照组(P<0.05),胃肠功能恢复时间、行走时间、住院时间均低于对照组,2组比较差异有统计学意义(P<0.05),肾上腺素和皮质醇HAMA评分无统计学意义(P>0.05),试验组患者术后皮质醇、肾上腺素HAMA评分明显低于对照组,2组间差异有统计学意义(P<0.05)。治疗后,试验组血清总胆红素、直接胆红素、丙氨酸转氨酶、碱性磷酸酶均显著低于对照组,2组比较差异有统计学意义(P<0.05)。试验组胆瘘、胆道出血、急性胰腺炎等并发症发生率低于对照组,2组比较差异有统计学意义(P<0.05)。结论腹腔镜联合十二指肠镜治疗胆囊结石合并胆总管结石具有较高的临床价值,值得推广。更多还原

【Abstract】 Objective To investigate the clinical value of laparoscopy combined with duodenoscopy in treatment of cholelithiasis combined with choledocholithiasis.Methods A total of 78 patients with choledocholithiasis and cholecystolithiasis who were admitted and treated in our hospital from April 2018 to June 2019 were enrolled in the study,who were randomly divided into experimental group and control group. The clinical indexes and complications were observed and comapred between the two groups.Results The operation time in experimental group was significantly higher than that in control group(P<0.05). The recovery time of gastrointestinal function,walking time and the length of staying in hospital in experimental group were significantly shorter than those in control group(P<0.05). After operation the cortisol levels and HAMA scores in hospital in experimental group were significantly lower than those in control group(P<0.05),however,the serum levels of total bilirubin,direct bilirubin,alanine aminotransferase and alkaline phosphatase in experimental group were significantly lower than those in control group(P<0.05). Moreover the incidence rates of complications in experimental group were significantly lower than those in control group(P<0.05).Conclusion The laparoscopy combined with duodenoscopy in treatment of cholelithiasis combined with choledocholithiasis has higher clinical value,therefor, it is worth popularizing in clinical practice.更多还原