摘要
目的观察小柴胡汤联合腹腔镜胆囊切除术治疗胆囊结石并发胆囊炎疗效。方法将90例住院患者按照随机数字表法分为两组。对照组46例腹腔镜胆囊切除术,术后常规抗感染、止血、营养支持。治疗组44例术后3 d加用小柴胡汤,手术及术后常规治疗同对照组。观测临床症状、术后引流量、术后排气时间、术后下床活动时间、住院时间、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酸转肽酶(GGT)、血清总胆红素(TBil)。治疗14 d,判定疗效。结果治疗组显效22例,有效20例,无效4例,总有效率(91.30%,42/46);对照组显效15例,有效23例,无效6例,总有效率(86.36%,38/44);两组差异无统计学意义(P>0.05)。术后引流量、术后首次排气时间、术后下床活动时间治疗组均短于对照组(P<0.05),住院时间两组差异无统计学意义(P>0.05)。ALT、AST、TBiL两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05),GGT两组均间无统计学意义(P>0.05)。结论强小柴胡汤联合腹腔镜胆囊切除术治疗胆囊结石并发胆囊炎,疗效满意,值得推广。
Objective: To observe the effect of Xiaochaihu decoction combined with laparoscopic cholecystectomy in the treatment of cholecystolithiasis with cholecystitis. Methods Ninety inpatients were randomly divided into two groups. In the control group,46 cases underwent laparoscopic cholecystectomy with routine anti infection,hemostasis and nutritional support. Forty-four cases in the treatment group were treated with Xiaochaihu decoction 3 days after operation. The operation and routine treatment were the same as those in the control group. We observed clinical symptoms,postoperative drainage,postoperative exhaust time,post-operative bed activity time,hospital stay,alanine aminotransferase,aspartate aminotransferase,l-glutamate-to-peptidase and serum total bilirubin. Results In the treatment group,22 cases were significantly effective,20 cases were effective and 4 cases were ineffective,and the total effective rate was( 91. 30%,42/46). In the control group,15 cases were significantly effective,23 cases were effective and 6 cases were ineffective,and the total effective rate was( 86. 36%,38/44). There was no significant difference between the two groups( P > 0. 05). The postoperative drainage volume,the first exhaust time after operation and the time of getting out of bed in the treatment group were shorter than those in the control group( P < 0. 05). There was no significant difference in hospitalization time between the two groups( P >0. 05). The levels of ALT,AST and TBi L were improved( P < 0. 05) and were better than those in the control group( P <0. 05). There was no significant change of GGT between the two groups( P > 0. 05). Conclusion The combination of Xiaochaihu decoction and laparoscopic cholecystectomy in the treatment of cholecystolithiasis complicated with cholecystitis. The curative effect is satisfactory,and it is worthy of promoting.
作者
张朝阳
ZHANG Chaoyang(Surgery of Hepatobiliary Hernia of The First People's Hospital of Ruzhou,Ruzhou 467599,Henan,China)
出处
《实用中医内科杂志》
2020年第1期75-77,共3页
Journal of Practical Traditional Chinese Internal Medicine
关键词
胆囊结石
胆囊炎
腹腔镜胆囊切除术
小柴胡汤
肝功能
cholecystolithiasis
cholecystitis
laparoscopic cholecystectomy
Xiaochaihu decoction
liver function
作者简介
张朝阳(1982-),男,河南汝州人,主治医师,硕士,研究方向:肝胆脾胰及腹股沟疝。
