关键词: 肝内胆管结石, 经皮经肝胆道镜, 硬镜碎石术, 肝功能, 生活质量, 安全性

Abstract:

Objective To investigate the clinical effect of percutaneous transhepatic cholangioscopy (PTCS) hard lens lithotripsy in the treatment of intrahepatic bile duct stones. Method From March 2019 to January 2022, 40 patients with hepatolithiasis admitted to Yanting County People's Hospital, were selected and divided into the observation group and the control group according to the random number table, with 20 patients in each group. The patients in the control group were treated with traditional laparoscopic intrahepatic bile duct lithotomy, and the patients in the observation group were treated with PTCS hard lens lithotripsy. The patients in both groups were followed up for 3 months after operation. The operation related indexes, liver function level, quality of life, recurrence and complications of the two groups were compared. Result The intraoperative bleeding volume of the patients in the observation group was lower than that in the control group, and the hospital stay, postoperative exhaust time, and operation time were shorter than those in the control group. The success rate of primary lithotripsy and the stone clearance rate 2 weeks after operation were higher than those in the control group, with significant differences (P ＜ 0.05). The levels of serum alanine aminotransferase, glutamic oxaloacetic transaminase, total bilirubin and serum albumin in the two groups were significantly lower than those in the control group 2 weeks after operation; The scores of physiological function, somatic pain, health status and emotional function of the patients in the two groups increased 3 months after operation compared with those before operation, and the scores in the observation group were significantly higher than those in the control group; Within 3 months after operation, the total incidence of complications and recurrence rate in the observation group were lower than those in the control group, with significant differences (P ＜ 0.05). Conclusion PTCS hard lens lithotripsy can effectively reduce liver injury, restore liver function, improve patients' quality of life, reduce the risk of complications and the possibility of stone recurrence.

Key words: Hepatolithiasis, Percutaneous transhepatic cholangioscopy, Hard mirror lithotripsy, Liver function, Quality of life, Security