标题：纤维胆道镜联合钬激光治疗胆道结石对患者血清CA19-9及CEA表达的影响

      作者：林关朋，张萍，古永强，陈湛科    (蕉岭县人民医院普通外科，广东 梅州 514199)

      卷次： 2017年28卷24期

      【摘要】 目的 观察纤维胆道镜联合钬激光治疗胆道结石对患者血清糖类抗原 19-9 (CA19-9)、癌胚抗原(CEA)表达的影响。方法 选择蕉岭县人民医院普通外科2016年1月至2017年3月收治的93例胆管结石合并胆囊结石或肝胆管结石患者，根据患者意愿分为两组，对照组46例采用开放性取石术，观察组47例采用纤维胆道镜联合联合钬激光碎石术，两组患者均于入院第2天、术后1周抽取清晨空腹外周静脉血送检，采用化学发光法检测血清CA19-9、CEA水平。结果 观察组患者术后1周的血清CA19-9、CEA水平分别为(16.71±2.53)、(2.55±0.37) μg/mL，均低于对照组的(27.32±4.18)、(3.62±0.53) μg/mL，且两组患者术后1周的血清CA19-9、CEA水平均低于术前，差异均有统计学意义(P<0.05)；观察组患者术前CA19-9、CEA阳性率分别为 63.83%、57.45%，术后 1周分别为 12.77%、10.64%，显著低于术前，也低于对照组术后1周的36.96%、30.43%，差异均有统计学意义(P<0.05)。结论 纤维胆道镜联合钬激光治疗胆道结石能降低患者血清CA19-9、CEA表达，术后炎症反应轻，是微创有效的手术方法，具有推广价值。
      【关键词】 纤维胆道镜；钬激光；胆道结石；糖类抗原19-9；癌胚抗原；影响
      【中图分类号】 R657.4+2 【文献标识码】 A 【文章编号】 1003—6350（2017）24—4004—03

Effect of fiber optic choledochoscope combined with holmium laser lithotripsy on serum CA19-9 and CEA in thetreatment of bile duct stones.
LIN Guan-peng, ZHANG Ping, GU Yong-qiang, CHEN Zhan-ke. Department of GeneralSurgery, the People's Hospital of Jiaoling County, Meizhou 514199, Guangdong, CHINA
【Abstract】 Objective To observe the effect of fiber optic choledochoscope combined with holmium laser litho-tripsy on the expression serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in the treat-ment of bile duct stones. Methods A total of 93 cases of patients bile duct stones complicated with gallstones or hepato-lithiasis, who admitted to Department of General Surgery of the People's Hospital of Jiaoling County from January 2016to March 2017, were selected and divide into the control group and the observation group according to the patient'swillingness for the treatment methods. The control group (n=46) was treated with open surgery for stone, and the ob-servation group (n=47) was treated with fiber optic choledochoscope combined with holmium laser lithotripsy. Theearly morning fasting peripheral venous blood samples of the two groups were collected at second day after admis-sion and one week after operation, and the serum levels of CA19-9 and CEA were detected by chemiluminescencemethod. Results One week after the operation, the serum levels of CA19-9 and CEA in the observation group·论 著·doi:10.3969/j.issn.1003-6350.2017.24.015基金项目：广东省梅州市科技计划项目（编号：2016B129）