【作者】 陈水平；

【导师】 邵江华；

【作者基本信息】 南昌大学 ， 外科学， 2008， 硕士

【摘要】 目的探讨胆管结石手术引流方式随诊断技术和手术技巧的提高所发生的变迁。方法一、收集有资料记载的近22年(1986年1月——2007年12月)来自南昌大学第二附属医院胆管结石的病人资料。二、整理资料,得出病人的一般情况:病人的发病年龄、性别、结石的分布部位、病人采用了哪些诊断方法和治疗手段,以图表的形式将其列举出来。三、将这22年病例资料中手术引流的方式——T管引流和胆肠吻合引流的资料按1986年——1996年和1997年——2007年划分为二个时间段,汇总成四格表,用SPSS软件进行统计学分析。四、分析资料,探讨胆管结石手术引流方式变迁的原因。五、通过查阅文献资料了解上世纪60年代到现在我国胆管结石的治疗状况,了解我国胆管结石病人手术引流方式的变迁,并分析导致这些变化的可能原因。结果一、胆管结石的病人中女性的比例高于男性,且在上世纪80年代至今这个变化不是很大。二、结石的发病年龄高龄化,发病的年龄高峰有向后推移的趋势。三、上世纪60—80年代初、1986—1996年、1997—2007年这三个时间段胆管结石病人中T管引流和胆肠吻合引流在同期行手术治疗的病人中百分比分别是:74.70%和16.90%、54.13%和37.00%、67.68%和13.10%。四、通过统计学分析发现两组病例资料中T管引流和胆肠吻合百分率存在差异(p<0.001)。结论过去的近50年来,我国胆管结石病人手术引流方式经历了胆道探查+T管引流——胆肠吻合——病灶根治+T管引流三个阶段。更多还原

【Abstract】 ObjectiveTo evaluate the diversify on biliary drainage modus of calculus of bile duct following the improvement of diagnostic and surgical technique .Methods1.The clinical records of patients with calculus of bile duct who treated in the second affiliated hospital of Nanchang University in recent 22 years(1986-2007) were collected and to get the general information, such as the age of onset,the gender,the calculary distribution, the methods of diagnosis and therapy. 2. The charged tendency and reasons of biliary drainage modus which T-Tube drain and chole-intestinal anastomosis were analyzed. 3. To compare the data of our hospital with references about biliary drainage modus and analyze the possible reason of appearing these differences.Results1.The percentage of female patients of calculus of bile duct is higher than male patients through the statistical analysis of case data.The percentage of changing is ignore from 1980s to now.2.We discovered that the peak of age of onset is becoming older.3.In 1960-1980,1986-1996 and 1997-2007,the percentage of T-Tube Drain and chole-intestinal anastomosis in synchronized operation therapy is 74.70% with 16.90%、54.13% with 37.00%、67.68% with 13.10%,respectively.ConclusionsIn the past 50 years, the biliary drainage modus of calculus of bile duct in our country experienced 3 different periods,including biliary tract exploration + T-Tube Drain, chole-intestinal anastomosis and radical cure of the focus of infection + T-Tube Drain.更多还原