中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
5期
627-630
,共4页
胆总管结石/外科学%括约肌切开术,内窥镜/方法%气囊扩张术/方法%治疗结果
膽總管結石/外科學%括約肌切開術,內窺鏡/方法%氣囊擴張術/方法%治療結果
담총관결석/외과학%괄약기절개술,내규경/방법%기낭확장술/방법%치료결과
Choledocholithiasis/surgery%Sphincterotomy,endoscopic/methods%Balloon dilatation/methods%Treatment outcome
目的 观察经内镜十二指肠乳头小切开联合气囊扩张治疗胆总管结石的有效性、安全性,探讨如何减少近期、远期并发症的发生.方法 将本院确诊的胆总管结石患者120例,按随机数字表法分为三组,分别采用经内镜十二指肠乳头小切开联合气囊扩张术(A组)40例、经内镜十二指肠乳头切开术[(EST)B组]40例、经内镜乳头扩约肌气囊扩张术[(EPBD)C组]40例,观察三组的手术疗效及术后近期远期并发症的发生率.结果 (1)三组患者总取石率无差异;A组与B组一次取石率差异无统计学意义(P＞0.05),但均高于C组(P＜0.05);而C组碎石率高于A组及B组(P＜0.05).(2)A组和C组术后出血的发生率低于B组,A组和B组术后胰腺炎的发生率低于C组.(3)在远期并发症中,A组未发生反流性胆管炎和结石复发,A组术后结石复发率低于B组及C组(P＜0.05),A组和C组胆道积气征发生率明显低于B组.结论 经内镜十二指肠乳头小切开联合气囊扩张在治疗胆总管结石的疗效方面与EST相当,优于EPBD组,其术后近期及远期并发症发生率低于EST组及EPBD组.
目的 觀察經內鏡十二指腸乳頭小切開聯閤氣囊擴張治療膽總管結石的有效性、安全性,探討如何減少近期、遠期併髮癥的髮生.方法 將本院確診的膽總管結石患者120例,按隨機數字錶法分為三組,分彆採用經內鏡十二指腸乳頭小切開聯閤氣囊擴張術(A組)40例、經內鏡十二指腸乳頭切開術[(EST)B組]40例、經內鏡乳頭擴約肌氣囊擴張術[(EPBD)C組]40例,觀察三組的手術療效及術後近期遠期併髮癥的髮生率.結果 (1)三組患者總取石率無差異;A組與B組一次取石率差異無統計學意義(P＞0.05),但均高于C組(P＜0.05);而C組碎石率高于A組及B組(P＜0.05).(2)A組和C組術後齣血的髮生率低于B組,A組和B組術後胰腺炎的髮生率低于C組.(3)在遠期併髮癥中,A組未髮生反流性膽管炎和結石複髮,A組術後結石複髮率低于B組及C組(P＜0.05),A組和C組膽道積氣徵髮生率明顯低于B組.結論 經內鏡十二指腸乳頭小切開聯閤氣囊擴張在治療膽總管結石的療效方麵與EST相噹,優于EPBD組,其術後近期及遠期併髮癥髮生率低于EST組及EPBD組.
목적 관찰경내경십이지장유두소절개연합기낭확장치료담총관결석적유효성、안전성,탐토여하감소근기、원기병발증적발생.방법 장본원학진적담총관결석환자120례,안수궤수자표법분위삼조,분별채용경내경십이지장유두소절개연합기낭확장술(A조)40례、경내경십이지장유두절개술[(EST)B조]40례、경내경유두확약기기낭확장술[(EPBD)C조]40례,관찰삼조적수술료효급술후근기원기병발증적발생솔.결과 (1)삼조환자총취석솔무차이;A조여B조일차취석솔차이무통계학의의(P＞0.05),단균고우C조(P＜0.05);이C조쇄석솔고우A조급B조(P＜0.05).(2)A조화C조술후출혈적발생솔저우B조,A조화B조술후이선염적발생솔저우C조.(3)재원기병발증중,A조미발생반류성담관염화결석복발,A조술후결석복발솔저우B조급C조(P＜0.05),A조화C조담도적기정발생솔명현저우B조.결론 경내경십이지장유두소절개연합기낭확장재치료담총관결석적료효방면여EST상당,우우EPBD조,기술후근기급원기병발증발생솔저우EST조급EPBD조.
Objective To explore the therapeutic efficacy and safety of endoscopic sphincterotomy joint balloon dilatation in the treatment of common bile duct calculi in order to reduce the recent and long-term complications.Methods A total of 120 cases of patients with common bile duct calculi was grouped into three groups:endoscopic sphincterotomy joint balloon dilatation,endoscopic sphincterotomy (EST),and endoscopic papillo-sphincter balloon dilatation (EPBD).The operative efficacy of three groupsand the incidence of postoperative immediate and long-term complications were observed and compared.Results No difference was found in total stone-free rate among three groups.No significant difference was found in a stone-free rate and lithotripsy rate between endoscopic sphincterotomy joint balloon dilatation and EST groups (P ＞ 0.05),however,those parameters in the former two groups were better than EPBD group (P ＜ 0.05).The incidence of postoperative bleeding in the endoscopic sphincterotomy joint balloon dilatation group is lower than EST group.The incidence of postoperative pancreatitis in the endoscopic sphincterotomy joint balloon dilatation and EST groups was lower than the EPBD group(P ＜ 0.05).For the long-term complications,the incidence of reflux cholangitis in the endoscopic sphincterotomy joint balloon dilatation group was lower than the EST group (P ＜ 0.05).The recurrence rate of postoperative bile duct calculi in the endoscopic sphincterotomy joint balloon dilatation group was lower than the EST and EPBD groups.Conclusions For the endoscopic sphincterotomy joint balloon dilatation in the treatment of common bile duct calculi,its curative effect was the same as the EST,but better than EPBD; it had a lower incidence of immediate and long-term complications than EST and EPBD.
