【摘要】 目的 比较双镜联合与开腹手术在肝内胆管结石患者中的应用效果。方法 选取2016年1月至2019年12月福建省漳州市医院收治的162例肝内胆管结石患者作为研究对象，采用随机数字表法将其分为对照组81例和观察组81例。对照组采用传统开腹手术，观察组采用双镜联合手术。比较两组患者的治疗有效率、临床指标、炎症反应、并发症总发生率及疼痛评分情况。结果 观察组总有效率高于对照组，差异有统计学意义（P<0.05）。观察组手术时间、胃肠功能恢复时间、引流管拔出时间、下床活动时间，术后住院时间均短于对照组，术中出血量低于对照组，差异有统计学意义（P<0.05）。观察组患者治疗后白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子（TNF-α）水平均低于对照组，差异有统计学意义（P<0.05）。观察组并发症总发生率低于对照组，差异有统计学意义（P<0.05）。观察组术后1、3 d时视觉模拟评分法（VAS）评分均低于对照组，差异有统计学意义（P<0.05）。结论 在肝内胆管结石治疗过程中，与开腹手术方式相比，双镜联合方式效果更加理想，对于减少患者疼痛感、降低并发症总发生率具有积极影响，具有临床使用价值。更多还原

【Abstract】 Objective To compare the application effect of dual mirror combined with open surgery in patients with intrahepatic bile duct stones. Methods A total of 162 patients with intrahepatic bile duct stones admitted to Zhangzhou Hospital from January 2016 to December 2019 were selected as the study subjects. They were divided into control group of 81 cases and observation group of 81 cases using random number table method. The control group was treated with traditional laparotomy, while the observation group was treated with dual mirror surgery. The treatment effectiveness, clinicalindicators,inflammatory reactions, complication rates, and pain scores of the two groups of patients were compared. Results The total effective rate of the observation group was higher than that of the control group, with statistically significant difference(P<0.05). The operative time, gastrointestinal function recovery time, drainage tube removal time, ambulatory time, and postoperative hospitalization time of the observation group were shorter than those of the control group, intraoperative bleeding was less than that of the control group, with statistically significant differences(P<0.05). After treatment, interleukin-6(IL-6), interleukin-8(IL-8), and tumor necrosis factor(TNF-α) of the observation group were lower than those of the control group, with statistically significant differences(P<0.05). The total incidence of complications of the observation group was lower than that of the control group, with statistically significant difference(P<0.05). The visual aualogue scale(VAS) score of the observation group was lower than that of the control group on the 1stand 3 rdpostoperative days, with statistically significant differences(P<0.05). Conclusion In the treatment of intrahepatic bile duct stones, compared with open surgery, the dual mirror combined approach has a more ideal effect, has a positive impact on reducing pain and complications in patients, and has clinical value.更多还原