早期夹闭T管对胆总管探查术后消化功能恢复的影响
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摘要
目的探讨早期夹闭T管对胆总管探查术后消化功能恢复的影响。方法将择期行胆总管探查的60例患者随机分为两组,各30例。对照组采取常规方法夹闭T管,研究组根据术后胆总管压力及流速监测早期夹闭T管。比较两组患者治疗效果、并发症及术后相关指标恢复情况。结果经治疗,两组患者均顺利康复出院。两组并发症发生率比较,差异无统计学意义(P>0.05);研究组患者夹、闭管时间均早于对照组(P<0.01),术后10 d内食欲评分高于对照组(P<0.01),总胆汁引流量少于对照组(P<0.01)。结论胆总管探查术后早期夹闭T管可以减少胆汁丢失量,促进消化功能的恢复。
Objective To investigate influence of early clamping and closing T tube on the function of digestive system in the cases treated by common bile duct exploration. Methods Randomized sixty patients with choledocholithiasis to two groups of thirty,for the research group clamping or closing T tube drainage gradually by examming the pressure and flow velocity of common bile duct continually,and the control group clamping or closing T tube conventionally,and then the curative efficacy,the related markers and the complications incidence were compared between the two groups postoperatively. Results The times of clamping and closing T tube in research group were earlier than those of the control group. No difference in the complications incidence was observed between both groups( P > 0. 05). The mean appetite score within 10 days in research group was higher than that of the control( P < 0. 01),the total volume of biliary drainage was less than that of the control group( P < 0. 01). Conclusion Early clamping and closing T tube can reduce the postoperative loss of bile and promote the recovery of liver and digestive function.
Objective To investigate influence of early clamping and closing T tube on the function of digestive system in the cases treated by common bile duct exploration. Methods Randomized sixty patients with choledocholithiasis to two groups of thirty,for the research group clamping or closing T tube drainage gradually by examming the pressure and flow velocity of common bile duct continually,and the control group clamping or closing T tube conventionally,and then the curative efficacy,the related markers and the complications incidence were compared between the two groups postoperatively. Results The times of clamping and closing T tube in research group were earlier than those of the control group. No difference in the complications incidence was observed between both groups( P > 0. 05). The mean appetite score within 10 days in research group was higher than that of the control( P < 0. 01),the total volume of biliary drainage was less than that of the control group( P < 0. 01). Conclusion Early clamping and closing T tube can reduce the postoperative loss of bile and promote the recovery of liver and digestive function.
引文
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[2]Li YL,Geng JL,Jia YM,et al.Clinical study of percutaneous transhepatic balloon dilation:a novel procedure for common bile duct stone[J].Zhonghua Yi Xue Za Zhi,2013,93(45):3586-3589.
[3]汪小万,赵中伟,王文卿,等.快速康复外科理念在开腹胆总管探查术中的应用研究[J].肝胆外科杂志,2015,23(2):141-144.
[4]马先仕,王雄彪,肖绪鹏,等.快速康复外科在腹腔镜下胆总管结石手术的临床应用[J].中华实验外科杂志,2015,32(2):425-426.
[5]蔡圆圆,郑晓倩,胡巧苗.胆总管压力监测指导T型管早期夹闭的效果[J].解放军护理杂志,2012,29(10A):45-46.
[6]任瑞芳,张川蓉,林秀红,等.胆总管压力监测确定胆总管探查术后T型管夹管时机探讨[J].护理学报,2008,15(3):1-3.
[7]林凌.胆总管压力动态监测在个体化夹管及术后快速康复中的应用[J].中国中西医结合外科杂志,2016,22(1):48-50.
[8]Li T,Apte U.Bile acid metabolism and signaling in cholestasis,inflammation,and cancer[J].Adv Pharmacol,2015,74:263-302.
[9]刘庆国,李向农.胆总管压力及流速监测指导夹闭T管的临床研究[J].陕西医学杂志,2017,46(6):753-754,759.
[10]陈孝平,汪建平.外科学[M].8版.北京:人民卫生出版社,2013:447-448.
[11]田华捷,冯琴,胡义扬.调节肠道菌群在中医药治疗非酒精性脂肪性肝病中的作用和意义[J].临床肝胆病杂志,2015,31(7):1042-1045.
[12]Schaap FG,Trauner M,Jansen PL.Bile acid receptors as targets for drug development[J].Nat Rev Gastroenterol Hepatol,2014,11(1):55-67.