摘要
Abstract
Objective To observe the clinical effect of ursodeoxycholic acid capsules combined with laparoscopic-assisted choledochoscopic lithotomy in the treatment of intrahepatic and extrahepatic bile duct stones.Methods Patients with intrahepatic and extrahepatic bile duct stones were divided into the control group and the treatment group.The control group was treated with laparoscopic-assisted choledochoscopic lithotomy,and was given general maintenance treatment after operation,such as anti infection,liver protection,and nutritional support.On this basis,the treatment group was treated with ursodeoxycholic acid capsules(0.25 g,tid,orally administration,for 6 months).The symptom disappearance rate,liver function indicators[glutamic-pyruvic transaminase(GPT),glutamic oxalacetic transaminase(GOT),total bilirubin(TBIL)],lipid metabolism indicators[total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL)]and stone recurrence rate were compared between the two groups.The incidence rates of postoperative complications were calculated.Results Forty-five cases were included in the treatment group and forty-three cases in the control group,respectively.After treatment,the total effective rates in the treatment group and the control group were 95.56％(43 cases/45 cases)and 81.40％(35 cases/43 cases)(P＜0.05).Six months after surgery,the disappearance rates of upper abdominal pain in the treatment group and the control group were 95.56％(43 cases/45 cases)and 81.40％(35 cases/43 cases);the disappearance rates of hepatic tenderness were 100.00％(45 cases/45 cases)and 86.05％(37 cases/43 cases);GPT levels were(31.54±6.27)and(38.29±6.63)U·L-1;GOT levels were(38.75±5.52)and(43.46±5.08)U·L-1;total bilirubin(TBIL)levels were(26.57±6.39)and(32.28±7.61)μmol·L-1;total cholesterol(TC)levels were(5.29±1.06)and(6.12±1.03)mmol·L-1;triglyceride(TG)levels were(1.45±0.43)and(1.69±0.46)mmol·L-1;high density lipoprotein(HDL)levels were(1.69±0.36)and(1.51±0.39)mmol·L-1;stone recurrence rates were 0(0 cases/45 cases)and 11.63％(5 cases/43 cases).The differences between groups were statistically significant(all P＜0.05).The main adverse drug reactions in the treatment group were nausea and diarrhea,while there were no adverse drug reactions in the control group.The total incidence of adverse drug reactions in the treatment group and control group were 6.67％(3 cases/45 cases)and 0(0 cases/43 cases),with no statistically significant difference(P＞0.05).Conclusion The application of ursodeoxycholic acid capsules after laparoscopic-assisted choledochoscopic lithotomy can promote the improvement of clinical symptoms and liver function in patients with intrahepatic and extrahepatic bile duct stones,accelerate lipid metabolism,and prevent stone recurrence.关键词
熊去氧胆酸胶囊/肝内外胆管结石/胆道镜取石术/临床疗效/结石复发Key words
ursodeoxycholic acid capsule/intrahepatic and extrahepatic bile duct stones/choledochoscopic lithotomy/clinical effect/stone recurrence分类
医药卫生
