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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (03) : 339 -342. doi: 10.3877/cma.j.issn.1674-3946.2021.03.028

所属专题: 文献

论著

胆囊切除术后胆总管结石应用ERCP术的临床效果及对免疫功能与肝胆指标的影响
张凤娇1,(), 刘曲1, 刘才德2   
  1. 1. 110001 中国医科大学附属盛京医院普外科
    2. 050055 河北省人民医院肝胆外科
  • 收稿日期:2020-01-23 出版日期:2021-06-26
  • 通信作者: 张凤娇

Clinical effect of ERCP on choledocholithiasis after cholecystectomy and its influence on immune function and hepatobiliary index

Fengjiao Zhang1,(), Qu Liu1, Caide Liu2   

  1. 1. Department of General Surgery, Shengjing Hospital, China Medical University Liaoning 110001, China
    2. Department of Hepatobiliary Surgery, Hebei Provincial People’s Hospital, Hebei 050055, China
  • Received:2020-01-23 Published:2021-06-26
  • Corresponding author: Fengjiao Zhang
  • Supported by:
    Project of Hebei Provincial Health and Family Planning Commission(20180057)
引用本文:

张凤娇, 刘曲, 刘才德. 胆囊切除术后胆总管结石应用ERCP术的临床效果及对免疫功能与肝胆指标的影响[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(03): 339-342.

Fengjiao Zhang, Qu Liu, Caide Liu. Clinical effect of ERCP on choledocholithiasis after cholecystectomy and its influence on immune function and hepatobiliary index[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(03): 339-342.

目的

探讨胆囊切除术后胆总管结石应用ERCP术的临床效果及对免疫功能与肝胆指标的影响。

方法

收集2014年1月至2018年12月胆囊切除术后胆总管结石患者86例,随机分为ERCP组和腹腔镜组,各43例。ERCP组给予ERCP术治疗,腹腔镜组给予常规腹腔镜探查术治疗,采用SPSS23.0软件进行统计学分析,总有效率、结石残留率、结石复发率、胆道狭窄率、胆管炎率、及不良事件总发生率等计数资料采用卡方检验;T淋巴细胞水平及肝功能指标等计量资料采用独立t检验。P<0.05差异有统计学意义。

结果

ERCP组治疗后有效率97.7%高于腹腔镜组81.4%,不良反应发生率7.0%低于腹腔镜组28.0%(P<0.05),ERCP组治疗后CD3+、CD4+和CD8+T淋巴细胞水平变化程度小于腹腔镜组,治疗后血清GPT、AST、TBA等肝胆功能指标均低于腹腔镜组,以上差异均有统计学意义(P<0.05)。

结论

胆囊切除术后胆总管结石应用ERCP术具有良好的临床效果,可有效降低肝胆指标,对患者的免疫功能影响较小。

Objective

To investigate the clinical effect of ERCP on choledocholithiasis after cholecystectomy and its influence on immune function and hepatobiliary index.

Methods

86 cases of choledocholithiasis after cholecystectomy were collected in our hospital from January 2014 to December 2018 and randomly divided into ERCP group and Laparoscopic group, 43 cases in each group. The ERCP group was treated with ERCP, while the Laparoscopic group was treated with conventional laparoscopic exploration. Spss23.0 software was used for statistical analysis. The total effective rate, stone residual rate, stone recurrence rate, biliary stricture rate, cholangitis rate, and the total incidence of adverse events were measured by chi square test; T lymphocyte level and liver function index were measured by independent t test. The difference was statistically significant (P<0.05).

Results

The effective rate of ERCP group(97.7%) was higher than that of laparoscopic group (81.4%), and the incidence of adverse reactions(7.0%) was lower than that of laparoscopic group (28.0%) (P.The changes of CD3+, CD4+ and CD8+ T lymphocyte levels in the ERCP group were less than those in the Laparoscopic group. After treatment, the serum GPT, AST, TBA and other liver and gallbladder fsunction indexes were lower than those in the Laparoscopic group, with statistical significance (P<0.05).

Conclusion

ERCP has a good clinical effect on choledocholithiasis after cholecystectomy. It can effectively reduce the liver and gallbladder index and has little influence on the immune function of patients.

表1 86例胆囊切除术后胆总管结石患者不同术式两组患者一般资料比较(±s)
表2 86例胆囊切除术后胆总管结石患者不同术式两组患者疗效比较[例(%)]
表3 86例胆囊切除术后胆总管结石患者不同术式两组患者治疗后不良反应事件比较[例(%)]
表4 86例胆囊切除术后胆总管结石患者不同术式两组患者治疗前后免疫功能比较[(±s),%]
表5 86例胆囊切除术后胆总管结石患者不同术式两组患者治疗前后肝胆功能变化比较(±s)
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