16例改良胆管空肠襻吻合术式临床疗效评价研究.doc

16例改良胆管空肠襻吻合术式临床疗效评价研究【中图分类号】R657.4 【文献标识码】A【文章编号】1672－3783(2011)05－0001－01 【摘要】目的：通过对16例改良胆管空肠襻式吻合治疗胆道疾病的患者临床疗效观察，并与同期18例行胆管空肠Roux-en-Y吻合术的患者结果进行比较，以评价改良胆管空肠襻式吻合临床运用前景。方法：随机选取我院2009年1月-2010年12月间34例行改良胆肠吻合和Roux-en-Y吻合术患者的临床资料进行回顾性分析，重点观察两种术式的手术时间、肠功能恢复时间、胆道逆行感染的发生率等。结果：改良胆管空肠襻式吻合组手术完成时间及术后肠道功能恢复的时间均短于胆管空肠Roux-en-Y吻合术组的时间，术后发生胆管逆行感染的几率也明显低于胆管空肠Roux-en-Y吻合术组。结论：改良胆管空肠襻式吻合操作简单易行，安全可靠，术后逆行感染发生几率少，值得临床推广运用。 【关键词】改良胆肠吻合术 临床疗效 评价 胆道逆行感染 Improved jejunal loop in 16 cases of bile duct anastomosis Clinical Evaluation 【Abstract】Objective: 16 patients with bile duct jejunal loop anastomosis improved treatment of patients with biliary tract disease Clinical efficacy, and with the same period 18 cases of bile duct jejunum Roux-en-Y anastomosis in patients were compared to evaluate the improvement of bile duct jejunum prospects for clinical use loop anastomosis. Methods: A randomly selected hospital in January 2009 -2010 between the 34 cases in December improved cholangioenterostomy and Roux-en-Y anastomosis in patients with clinical data analysis, focused observation of two surgical operation time, bowel function recovery, the incidence of retrograde infection of biliary tract and so on. Results: Improved bile duct jejunum anastomosis group loop completion time of surgery and postoperative intestinal function recovery time was shorter in the bile duct jejunum Roux-en-Y anastomosis group of the time, postoperative risk of retrograde infection was significantly lower than the bile duct jejunal Roux-en-Y anastomosis group. Conclusion: The modified loop-type bile duct jejunum anastomosis operation is simple, safe, reliable, less likely after retrograde infection, is worthy of clinical use. 【Key words】 Modified choledochojejunostomy; clinical efficacy; evaluation; biliary retrograde infection 胆肠吻合术是修复胆道损伤［1］、肝外胆管病变切除后及治疗胆管结石和肝移植时重建胆道及处理胆道并发症的常用手术方式［2］。此术式较多，其中，又以胆管空场Roux-en-Y吻合术和襻式胆肠吻合术最常用。目前，胆管空场端―侧（Roux-en-Y）吻合术被学术界认为是一种逆行胆肠吻合术胆道感染发生率相对较低的术式，但其手术过程复杂、技术含量要求高，在基层医院开