原创《110例肝硬化合并胆结石外科治疗的临床效果》：这是一篇与胆结石论文范文相关的免费优秀学术论文范文资料,为你的论文写作提供参考。
[摘 要] 目的 分析肝硬化合并胆结石外科治疗的临床效果.方法 方便选择该院自2010年5月—2015年5月收治的110例肝硬化合并膽结石患者,所有患者均给予手术治疗,对治疗效果、并发症进行观察.结果 经治疗后,患者的有效率为91.82%（101/110）；手术所需时间为（54.39±9.38）min,术中出血量为（432.38±88.37）mL；经治疗后,患者ALT、AST及γ-GT指标与治疗前对比均有明显下降（P<0.05）；治疗后HBV-DNA、HBeAg阳性率与治疗前对比均有明显下降（P<0.05）；术后有7例患者出现了切口感染,5例出现了上消化道出血,3例出现了腹腔积液,并发症发生率为13.64%（15/110）.结论 给予肝硬化合并胆结石患者行手术治疗,可将ALT、AST、γ-GT等指标改善,疗效显著,值得使用.
[关键词] 肝硬化；胆结石；外科手术；临床效果
[中图分类号] R65 [文献标识码] A [文章编号] 1674-0742（2017）08（c）-0057-03
Clinical Effect of Surgical Treatment of Cirrhosis and Gall-stone
WU Yun-shu
Department of General Surgery, Sheyang Hospital of Traditional Chinese Medicine, Yancheng, Jiangsu Province, 224300 China
[Abstract] Objective To analyze the clinical effect of surgical treatment of cirrhosis and gall-stone. Methods Convenient selection 110 cases of patients with cirrhosis and gall-stone admitted and treated in our hospital from May 2010 to May 2015 were selected and treated with operation, and the treatment effect and complications were observed. Results After treatment, the effective rate, operation time needed and intraoperative bleeding amount of patients were respectively 91.82%（101/110）, （54.39±9.38）min and （432.38±88.37）mL, after treatment, the ALT, AST and γ-GT obviously decreased compared with those before treatment（P<0.05）, after treatment, the positive rates of HBV-DNA and HBeAg obviously decreased compared with those before treatment（P<0.05）, and there were 7 cases with incision infection after surgery and 5 cases with upper gastrointestinal hemorrhage and 3 cases with peritoneal effusion, and the incidence rate of complications was 13.64%（15/110）. Conclusion The operation treatment of cirrhosis and gall-stone patients can improve the ALT, AST, γ-GT, and the curative effect is obvious, which is worth application.
[Key words] Cirrhosis； Gall-stone； Surgical operation； Clinical effect
肝硬化会损害患者的肝功能,降低蛋白质合成能力,且多有静脉曲张的症状,行手术治疗,会有很大的风险,如术中出血量较大,术后出现感染、消化道出血等并发症[1],致使临床大夫多不选择此类治疗方式,但一直采取内科治疗,患者胆绞痛、黄疸及发热等症状难以缓解.可行腹腔镜手术,此类手术既可以缓解患者的病情,在术后出现并发症的机率也较低,现方便选择该院自2010年5月—2015年5月收治的110例肝硬化合并胆结石患者作为研究对象,现报道如下.
1 资料与方法
1.1 一般资料
方便选择该院收治的110例肝硬化合并胆结石患者,其中男46例,女64例,年龄为30～70岁,平均年龄为（48.39±19.23）岁,其中34例为酒精性肝硬化,61例为病毒性肝硬化,15例为其它类型肝硬化；62例为胆总管结石,30例为单纯胆囊结石,20例为胆囊结石合并胆总管结石；Child-Pugh 肝功分级：49例为,40例为B级,21例为C级.
1.2 方法
所有患者在手术前将相关检查做好,如血常规、B 超、肝功能检查等,并采取保肝治疗[2].全麻下实施腹腔镜手术,在剑突下、脐上分别做一切口,长度为1 cm,在右侧肋缘2 cm锁骨中线处切开一切口,长度为0.5 cm,在右侧肋缘下2 cm与腋前线处做一切口,长度也为0.5 cm,将腔镜器械置入；在术中根据患者具体病情采取不同的手术方式,有74例患者胆囊三角区域清晰,直接采取胆囊切除术；有15例患者为胆囊积液,对胆囊进行减压后切除胆囊；有14例患者胆囊三角解剖结构不清,且为多发性结石,将结石取出后切除胆囊；有7例患者胆囊三角粘连,实施顺逆结合术或胆囊大部切除术后处理.术后注意引流.
胆结石论文参考资料：
结论：110例肝硬化合并胆结石外科治疗的临床效果为关于本文可作为胆结石方面的大学硕士与本科毕业论文胆结石论文开题报告范文和职称论文论文写作参考文献下载。
