CAJ | 학술논문

目的：探讨选择性胆管插管对经内镜逆行性胰胆管造影术(Endoscopic retrograde cholangio-pan-creatography，ERCP)后胰腺炎发生率和严重程度的影响。方法随机抽取我院消化内科需要行ERCP手术的患者188例，根据导丝插入方法不同分为治疗组84例和对照组104例，治疗组采用双“十”字交叉标准选择性胆管插管技术，对照组行传统常规插管方法，术后比较两组患者胰腺炎和高淀粉酶血症的发生率、胰腺炎严重程度。结果两组患者胰腺炎发生情况比较，治疗组ERCP术后胰腺炎发生7例，其中轻、中、重度分别为6例、1例和0例，低于对照组的20例(其中轻、中、重度分别为12例、6例和2例)，差异有统计学意义(Z=-3.497，P=0.000；χ2=4.487，P=0.034)。两组患者高淀粉酶血症发生情况比较，治疗组高淀粉酶血症发生14例，低于对照组的32例，差异有统计学意义(χ2=5.000，P=0.025)。结论双“十”字交叉标准选择性胆管插管技术能够明显降低ERCP术后胰腺炎和高淀粉酶血症发生率，临床值得推广使用。
목적：탐토선택성담관삽관대경내경역행성이담관조영술(Endoscopic retrograde cholangio-pan-creatography，ERCP)후이선염발생솔화엄중정도적영향。방법수궤추취아원소화내과수요행ERCP수술적환자188례，근거도사삽입방법불동분위치료조84례화대조조104례，치료조채용쌍“십”자교차표준선택성담관삽관기술，대조조행전통상규삽관방법，술후비교량조환자이선염화고정분매혈증적발생솔、이선염엄중정도。결과량조환자이선염발생정황비교，치료조ERCP술후이선염발생7례，기중경、중、중도분별위6례、1례화0례，저우대조조적20례(기중경、중、중도분별위12례、6례화2례)，차이유통계학의의(Z=-3.497，P=0.000；χ2=4.487，P=0.034)。량조환자고정분매혈증발생정황비교，치료조고정분매혈증발생14례，저우대조조적32례，차이유통계학의의(χ2=5.000，P=0.025)。결론쌍“십”자교차표준선택성담관삽관기술능구명현강저ERCP술후이선염화고정분매혈증발생솔，림상치득추엄사용。
Objective To explore effect on incidence and severity of acute pancreatitis by selective bile duct cannulation in ERCP. Methods We selected one hundred and eighty-eight cases from the patients who needed ERCP in Endocrinology department in Chongqing Thirteen People's Hospital as research object,which were randomly divided into the treatment group (84 cases) and the control group (104 cases) according to the different guide wire inserted ways. The patients in the treatment group were treated with the“cross standard”selective bile duct intubation techniques, while the patients in the control group were given conventional bile duct intubation techniques. The results of incidence and severity of acute pancreatitis were analyzed. Results The number of pancreatitis occurred in the treatment group (7 cases) was less than that in the control group (20 cases). The difference was statistically significant (χ2=4.487, P=0.034). Among them, the number of patients in light, medium and heavy degree were 6 cases, 1 and 0 respectively in the treatment group, while they were 12 cases, 6 and 2 respectively in the control group. The difference was statistically sig-nificant (Z=-3.497, P=0.000). On the number of cases in high blood amylase, the treatment group (14 case) was smaller than the control group (32 cases). The difference was statistically significant (χ2=5.000,P=0.025). Conclusion Cross standard selective bile duct cannulation techniques can significantly reduce the incidence of postoperative ERCP pan-creatitis and high blood amylase. It is worth to be recommended in the clinical application.