肝方叶切除在胆管结石合并胆管狭窄治疗中价值分析.docVIP

肝方叶切除在胆管结石合并胆管狭窄治疗中价值分析 　　doi：10.3969/j.issn.1007-614x.2014.20.52 　　摘 要 目的：探讨肝方叶切除在胆管结石合并胆管狭窄中的应用价值。方法：2010年6月-2014年3月收治胆管结石合并胆管狭窄患者60例，按照手术方式的不同分为观察组40例和对照组20例，观察组采用肝方叶切除、肝胆管切开取石、整形、高位胆肠吻合术，对照组采用未进行肝方叶切除的手术方法，比较两组临床疗效。结果：观察组临床疗效的优良率显著高于对照组，残石率显著低于对照组，术后并发症显著少于对照组，术后1周时的丙氨酸转氨酶（ALT）、谷草转氨酶（AST）低于对照组，差异均有统计学意义（P0.05）。结论：肝方叶切除治疗胆管结石合并胆管狭窄的疗效满意，能够有效降低残石率和术后并发症，并能提高患者的肝功能，值得推广。 　　关键词 肝方叶切除 胆管结石 胆管狭窄 　　Value analysis of lobus quadratus hepatis resection in the treatment of bile duct stones with bile duct stricture 　　Zhao Jinliang 　　The Peoples Hospital of Wangcheng District，Changsha City，Hunan 410200 　　Abstract Objective：To explore the value of lobus quadratus hepatis resection in the treatment of bile duct stones with bile duct stricture.Methods：60 cases with bile duct stones and bile duct stricture were selected from June 2010 to March 2014.According to the different ways of operation，they were divided into the observation group of 40 cases and the control group with 20 cases.The observation group were treated with liver resection，biliary duct stone，plastic，high biliary intestinal anastomosis.The control group were treated with no liver resection method.We compared the clinical efficacy of two groups.Results：In the observation group，the clinical efficacy was significantly higher than the control group.The residual stone rate was significantly lower than the control group.The postoperative complications were significantly less than that of the control group.Alanine aminotransferase（ALT） and aspartate aminotransferase（AST） at 1 week after operation were lower than that of the control group.The differences were statistically significant（P0.05）.Conclusion：The curative effect of lobus quadratus hepatis resection in the treatment of bile duct stones with bile duct stricture is satisfying.It can effectively reduce the residual stone rate and postoperative complications，and can improve the liver function of patients.It is worthy of promotion. 　　Key words Lobus quadratus