RESUMO
Objective:To compare the clinical efficacy of percutaneous transhepatic choledochoscope lithotomy (PTCSL) with laparoscopic choledocholithotomy (LD) in treatment of choledocholithiasis.Methods:Data of 132 patients with choledocholithiasis treated at the First Affiliated Hospital of Guangzhou Medical University from July 2012 to December 2018 were retrospectively analyzed. There were 75 males and 57 females, with an average age of 62.7 years. For 76 patients underwent PTCSL (the PTCSL group) and 56 underwent LD (the LD group). The data of the patients the success rate of lithotomy, stone residual rate, operation time, postoperative complications and stone recurrence, chronic cholangitis, and acute cholangitis 1 month after operation were compared between the two groups.Results:The ratio of upper abdominal operation history and biliary tract infection in the PTCSL group was higher than that in the LD group, and the difference was statistically significant (both P<0.05). In the PTCSL group, the calculi were successfully removed in 64 patients in one treatment session, while residual calculi were removed through subsequent sinus choledochoscopy in 9 patients. In the remaining 3 patients, the residual calculi were removed with LD or laparotomy operations. Postoperative complications occurred in 14 patients (19.2%, 14/73). In the LD group, the calculi were successfully removed in one session in 46 patients while in 8 patients the residual calculi were removed by choledochoscopy (1 patient still had residual calculi after choledochoscopy). The remaining 2 patients underwent open surgery due to anatomical difficulties. Postoperative complications occurred in 11 patients (20.4%, 11/54). There were no significant differences between the two groups in the one-off stone removal rate, postoperative stone residual rate, final stone removal rate and postoperative complication rate (all P>0.05). The operation time of the PTCSL group was (156±60) min, which was significantly shorter than the LD group (203±59) min ( P<0.05). There was no significant difference between the two groups in the incidence of postoperative chronic cholangitis and recurrence rate of calculi (both P>0.05). The incidence of acute cholangitis in the PTSCL group was significantly higher than that in the LD group ( P<0.05). Conclusion:PTCSL was as safe and effective as LD, with fewer complications and faster recovery. It is especially suitable for patients with previous upper abdominal surgery, recurrence of calculi and repeated biliary tract infection.
RESUMO
Objective:To explore the influences of different sexes and ages on children static balance at the basis of quantitative comparison study of static postural balance of children aged 6-8(-year-odl).Method:A total of 499 children aged 6-8-year-old were recruited,which include 254 boys and 245 girls.Static postural balance test of these subjects was performed by using KY-1112 system for stabilometric analysis with subjects opening and closing eyes situations.Result:①There was a significant gender difference in static balance.At gender comparison,there was a significant difference on 3 indicators at the situations with eyes opening(P<0.05),and 3 indicators at the situations with eyes closing(P<0,01).②A significant difference Was shown in age comparison on 5 indicators(P<0.05).The mean of 5 indicators decreased with age growing.As compared with the value among Eve Area(with eyes opening and closing)and Track location Variance (with eyes opening).there Was a significant difference between children aged 8-year-old and 6-7-year-old(P<0.01),and no significant difference between 6-year-old and 7-year-old.There was a very significant difference on the LNG indicators at the situations with eyes opening and closing(P<0.01).③The value R indicator Was less than 1.Conclusion:To the children aged 6-8-year-old,there was significant gender difference in static balance,the balance function of girls was better than that of boys;there was significant age difference in static balance,with age growing the static balance rose also;relatively speaking,the gravity center shaking area was larger at forward and backward than that at leftward and rishtward.