【摘 要】
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目的 分析腹腔镜胆囊造瘘术联合术后胆道镜取石术治疗高龄急危重症胆囊结石患者的临床效果.方法 73例高龄急危重症胆囊结石患者,均接受腹腔镜胆囊造瘘术联合术后胆道镜取石术
【机 构】
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518000,广东省深圳市宝安人民医院集团第一医院
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目的 分析腹腔镜胆囊造瘘术联合术后胆道镜取石术治疗高龄急危重症胆囊结石患者的临床效果.方法 73例高龄急危重症胆囊结石患者,均接受腹腔镜胆囊造瘘术联合术后胆道镜取石术治疗.观察患者手术情况、并发症发生情况和复发情况以及术前、术后3 d肝功能各项指标[总胆红素(TB)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、白蛋白(ALB)]水平变化情况.结果 73例患者胆囊造瘘术均获得成功,平均手术时间(25.7±7.3)min;施术过程未发生胆漏、气胸、出血、胆道或胆管损伤等手术相关并发症;术后1个月,17例患者未发现结石,其余56例患者接受胆道镜取石术均获得成功,造瘘管拔除顺利.73例患者术后3 d TB、ALT、ALP、ALB水平分别为(23.17±2.19)μmol/L、(54.09±9.02)U/L、(84.92±13.71)U/L、(51.66±7.82)g/L,均优于术前的(32.09±2.73)μmol/L、(62.11±11.73)U/L、(174.83±10.26)U/L、(42.35±5.73)g/L,差异有统计学意义(P<0.05).术后所有患者均获得随访,随访率100％.随访过程中,6例患者复诊时经B超检查发现疑似结石,选用口服药物治疗,再次复查时3例患者疑似结石回声光团消失,3例患者明确复发(其中1例患者无症状提醒其仍需再次复查).结论 高龄急危重症胆囊结石患者实施腹腔镜胆囊造瘘术联合术后胆道镜取石术治疗安全、有效,能够帮助患者控制临床症状,有效清除结石,促进其及早康复.
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