老年医学与保健2024，Vol.30Issue(3)：808-812,5.
乳头括约肌小切开联合球囊扩张取石对老年复杂胆总管结石患者的取石效果及生活质量的影响
Effects of SEST combined with balloon dilation lithotomy on stone removal and quality of life in elderly patients with complex choledocholithiasis
摘要
Abstract
Objective To explore the effects of small endoscopic sphincterotomy(SEST)combined with balloon dila-tation lithotomy on complex choledocholithiasis in elderly patients and its influence on lithotomy time and incidence of acute pancreatitis.Methods 105 elderly patients with complex choledocholithiasis undergoing surgical treatment in Jiaozhou Central Hospital from June 2020 to December 2022 were selected.Among them,54 ones receiving SEST combined with balloon dilata-tion lithotomy were assigned to observation group,and 51 ones receiving SEST combined with conventional stone basket lithot-omy were assigned to control group.The surgical time,lithotomy conditions and recovery conditions were compared between the two groups.The incidence of complications such as perforation,delayed bleeding,acute pancreatitis,hyperamylasemia,biliary tract infection within 3 days after surgery were recorded and compared between the two groups.The stress response(cortisol,epinephrine)and risk score of disease recurrence within 24 hours after surgery were compared between the two groups.The changes in score of Gastrointestinal Quality of Life Index(GIQLI)were compared between the two groups before treatment and after 14 days of treatment.Results There was no statistical significance in surgical time between groups(P＞0.05).Compared with the control group,the lithotomy time in the observation group was shorter,the success rate of one-time lithotomy was higher,and the mechanical lithotripsy rate was lower(P＜0.05).There was no statistical difference in the pro-portion of patients with general anesthesia between the two groups(P＞0.05),but the postoperative ambulation time of general anesthesia patients and hospital stay in the observation group were shorter than those in the control group(P＜0.05).There was no significant difference in hospitalization cost between the two groups(P＞0.05).Within 3 days after surgery,the inci-dence of complications in the observation group was lower than that in the control group(P＜0.05).The levels of cortisol and epinephrine and score of disease recurrence after surgery of the observation group were lower than those of the control group(P＜0.05).After 14 days of treatment,the GIQLI scores of both groups were higher than those of the same group before treatment,and the scores of the observation group were higher than those of the control group(P＜0.05).Conclusion For elderly patients with complex choledocholithiasis,SEST combined with balloon dilatation lithotomy has high lithotomy efficien-cy.It can significantly reduce the incidence of complications after surgery and effectively improve the quality of life of patients,and has clinical application value.关键词
老年/胆总管结石/乳头括约肌切开/球囊扩张取石/取石时间Key words
elderly/choledocholithiasis/small endoscopic sphincterotomy/balloon dilatation lithotomy/lithotomy time引用本文复制引用
徐春晓,王红霞,吴美英,张立一..乳头括约肌小切开联合球囊扩张取石对老年复杂胆总管结石患者的取石效果及生活质量的影响[J].老年医学与保健,2024,30(3):808-812,5.基金项目
2022年度青岛市医药卫生科研指导项目(2022-WJZD122) （2022-WJZD122）
2022-2024年青岛市市级临床重点专科胃肠道肿瘤综合治疗专科资助 （）
