目的 探讨经皮肝穿刺软、硬质胆道镜联合治疗复杂性肝内外胆管结石的效果。方法 选取2016年1月—2018年6月54例复杂性肝内外胆管结石患者,根据随机数表法分为研究组(25例)与对照组(29例),研究组给予经皮肝穿刺软、硬质胆道镜联合治疗,对照组给予经皮肝穿刺硬质胆道镜治疗,对比两组手术时间、术中出血量、手术次数、住院时间、结石取净率和并发症。结果 与对照组比较,研究组手术时间较长,住院时间明显缩短,术中出血量(P＜0.05)和并发症较低(P＜0.05),结石取净率较高组(P＜0.05),但两组手术次数无差异(P＞0.05)。结论 经皮肝穿刺软硬质胆道镜联合治疗复杂性肝内外胆管结石疗效显著,可有效缩短住院时间,减少创伤,降低出血量,加快患者康复,值得推广。

Objective To investigate the efficacy of percutaneous transhepatic soft choledochoscopy combining with hard choledochoscopy in the treatment of complicated intrahepatic and extrahepatic bile duct stones.Method A total of 54 patients with complicated intrahepatic and extrahepatic bile duct stones were selected from our hospital from January 2016 to June 2018 and were divided into research group (n=25) and control group (n=29) according to random number table.The research group received percutaneous transhepatic soft choledochoscopy combining with hard choledochoscopy, and the control group received percutaneous transhepatic hard choledodcos copy.Operational time, intraoperative blood loss, operation frequency, length of hospital stay, stone removal rate, and complications between the two groups were compared.Results The research group had longer operation time, shorter hospital stay, less intraoperative blood loss, less complications, and higher stone removal rate (P < 0.05) than the control group, but there was no difference in the frequency of operations between the two groups (P>0.05).Conclusion Percutaneous transhepatic soft choledochoscopy combining with hard choledochoscopy for complicated intrahepatic and extrahepatic bile duct stones is effective, with shorter hospital stay, less trauma and operational blood loss, and faster recovery; thus it is worth of clinical promoting.