内镜下乳头括约肌小切开联合球囊扩张治疗胆管结石患者的疗效及对血清CCK-A、SREBP-2水平的影响

doi:10.3969/j.issn.1671-7171.2024.10.015

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摘要【目的】探讨内镜下乳头括约肌小切开联合球囊扩张治疗胆管结石的疗效及对血清胆囊收缩素A型受体(CCK-A)、胆固醇调节元件结合蛋白2(SREBP-2)水平的影响。【方法】选取2019年1月至2023年12月本院收治的196例胆管结石患者,根据随机数字表法将其分为观察组和对照组,每组98例。对照组患者采用内镜下乳头括约肌切开术,观察组患者行内镜下乳头括约肌小切开联合球囊扩张术。比较两组手术时间、出血量、住院时间、下床时间、胃肠功能恢复时间,比较两组取石率、结石复发率及术后并发症发生率。【结果】观察组手术时间、住院时间、下床时间、胃肠功能恢复时间短于对照组,出血量少于对照组,差异有统计学意义(P<0.05)。观察组一次取石成功率高于对照组(P<0.05),观察组机械碎石率、结石复发率低于对照组(P<0.05);观察组残余结石率与对照组比较,差异无统计学意义(P>0.05)。术后,两组患者CCK-A高于术前,SREBP-2低于术前;观察组术后CCK-A高于对照组,SREBP-2低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。【结论】内镜下乳头括约肌小切开联合球囊扩张术治疗胆管结石具有手术时间短、术后恢复快、术后胆囊功能恢复好、并发症少等优势。

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	汤文俊
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关键词 ：胆石/外科学, 括约肌切开术,内窥镜, 气囊扩张术, 受体, 胆囊收缩素A/血液, 胆固醇调节元件结合蛋白质2/血液

Abstract：【Objective】To explore the efficacy of endoscopic papillary mini-incision combined with balloon dilation in the treatment of bile duct stones and its impact on serum levels of cholecystokinin type A receptor (CCK-A) and cholesterol regulatory element binding protein 2 (SREBP-2). 【Methods】A total of 196 patients with bile duct stones admitted to our hospital from January 2019 to December 2023 were selected and divided into the observation group and the control group based on a random number table method, with 98 cases in each group. The patients in the control group underwent endoscopic sphincterotomy for gallstone surgery, while the patients in the observation group underwent endoscopic papillary mini-incision combined with balloon dilation. The operation time, blood loss, hospitalization, time to get-out-of bed, and gastrointestinal function recovery time were compared between the two groups. The stone removal rate, stone recurrence rate, and postoperative complication incidence were compared between the two groups as well. 【Results】The observation group had significantly lower operation time, blood loss,hospitalization time, time to get-out-of bed, and gastrointestinal function recovery time compared to the control group (P<0.05). The success rate for one time of stone removal in the observation group was higher than that in the control group (P<0.05), while the mechanical lithotripsy rate and stone recurrence rate in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the residual stone rate between the observation group and the control group (P>0.05). After surgery, the CCK-A of the two groups of patients was higher than that before surgery, and the SREBP-2 was lower than that before surgery. The postoperative CCK-A in the observation group was higher than that in the control group, while the postoperative SREBP-2 level was lower than that in the control group, with a statistically significant difference (P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】The combination of endoscopic papillary mini-incision and balloon dilation for the treatment of bile duct stones has advantages such as short surgical time, quick postoperative recovery, good postoperative gallbladder function recovery, and fewer complications.

Key words： Gallstones/SU Sphincterotomy, Endoscopic Balloon Dilatation Receptor, Cholecystokinin A/BL Sterol Regulatory Element Binding Protein 2/BL

收稿日期: 2024-01-10

中图分类号:

R657.42

通讯作者: *E-mail:qinxj@hotmail.com

引用本文:

汤文俊, 秦贤举. 内镜下乳头括约肌小切开联合球囊扩张治疗胆管结石患者的疗效及对血清CCK-A、SREBP-2水平的影响[J]. 医学临床研究, 2024, 41(10): 1508-1511.
TANG Wenjun, QIN Xianju. The Efficacy of Endoscopic Papillary Mini-incision Combined with Balloon Dilation in the Treatment of Patients with Bile Duct Stones and Impact on Serum Levels of CCK-A and SREBP-2. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1508-1511.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.10.015 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I10/1508

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