临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2014年
8期
746-748
,共3页
赵孝文%鲍峻峻%胡翠%丁浩%徐张巍%刘晓昌%梅俏%许建明
趙孝文%鮑峻峻%鬍翠%丁浩%徐張巍%劉曉昌%梅俏%許建明
조효문%포준준%호취%정호%서장외%류효창%매초%허건명
胆总管结石%胰腺炎%高淀粉酶血症%胰胆管造影术,内窥镜逆行%引流术
膽總管結石%胰腺炎%高澱粉酶血癥%胰膽管造影術,內窺鏡逆行%引流術
담총관결석%이선염%고정분매혈증%이담관조영술,내규경역행%인류술
choledocholithiasis%pancreatitis%hyperamylasemia%cholangiopancreatography,endoscopic retrograde%drainage
目的：探讨经内镜鼻胆管引流（ENBD）预防胆总管结石经内镜逆行胰胆管造影（ERCP）术后胰腺炎（PEP）及高淀粉酶血症的临床作用。方法收集2010年10月-2013年12月行ERCP取石治疗的胆总管结石患者560例，根据术中是否放置鼻胆管分为ENBD组（试验组）371例和非ENBD组（对照组）189例，观察术后3、24 h血清淀粉酶水平及PEP和高淀粉酶血症的发生率。两组间计量资料的比较采用t检验，率的比较采用卡方检验。结果试验组PEP及高淀粉酶血症发生率分别为8．1％（30/371）和13．7％（51/371），显著低于对照组13．8％（26/189）（χ2＝4．47，P＝0．034）和21．2％（40/189）（χ2＝5．06，P＝0．024）。试验组患者术后3及24 h血清淀粉酶值分别为（215．34±304．00）U/L、（199．38±273．32）U/L，显著低于对照组（283．28±261．76）U/L、（257．05±199．25）U/L，差异有统计学意义（t＝2．61、2．57，P均＝0．01）。结论 ENBD可有效预防PEP及高淀粉酶血症的发生。
目的：探討經內鏡鼻膽管引流（ENBD）預防膽總管結石經內鏡逆行胰膽管造影（ERCP）術後胰腺炎（PEP）及高澱粉酶血癥的臨床作用。方法收集2010年10月-2013年12月行ERCP取石治療的膽總管結石患者560例，根據術中是否放置鼻膽管分為ENBD組（試驗組）371例和非ENBD組（對照組）189例，觀察術後3、24 h血清澱粉酶水平及PEP和高澱粉酶血癥的髮生率。兩組間計量資料的比較採用t檢驗，率的比較採用卡方檢驗。結果試驗組PEP及高澱粉酶血癥髮生率分彆為8．1％（30/371）和13．7％（51/371），顯著低于對照組13．8％（26/189）（χ2＝4．47，P＝0．034）和21．2％（40/189）（χ2＝5．06，P＝0．024）。試驗組患者術後3及24 h血清澱粉酶值分彆為（215．34±304．00）U/L、（199．38±273．32）U/L，顯著低于對照組（283．28±261．76）U/L、（257．05±199．25）U/L，差異有統計學意義（t＝2．61、2．57，P均＝0．01）。結論 ENBD可有效預防PEP及高澱粉酶血癥的髮生。
목적：탐토경내경비담관인류（ENBD）예방담총관결석경내경역행이담관조영（ERCP）술후이선염（PEP）급고정분매혈증적림상작용。방법수집2010년10월-2013년12월행ERCP취석치료적담총관결석환자560례，근거술중시부방치비담관분위ENBD조（시험조）371례화비ENBD조（대조조）189례，관찰술후3、24 h혈청정분매수평급PEP화고정분매혈증적발생솔。량조간계량자료적비교채용t검험，솔적비교채용잡방검험。결과시험조PEP급고정분매혈증발생솔분별위8．1％（30/371）화13．7％（51/371），현저저우대조조13．8％（26/189）（χ2＝4．47，P＝0．034）화21．2％（40/189）（χ2＝5．06，P＝0．024）。시험조환자술후3급24 h혈청정분매치분별위（215．34±304．00）U/L、（199．38±273．32）U/L，현저저우대조조（283．28±261．76）U/L、（257．05±199．25）U/L，차이유통계학의의（t＝2．61、2．57，P균＝0．01）。결론 ENBD가유효예방PEP급고정분매혈증적발생。
Objective To investigate the clinical effect of endoscopic nasobiliary drainage (ENBD)in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP)pancreatitis (PEP)and hyperamylasemia in patients with choledocholithiasis.Methods A total of 560 patients with choledocholithiasis who underwent ERCP from October 2010 to December 2013 were included in the study.ENBD was performed in 371 patients (test group),and the other 189 patients were designated as control group.Serum amylase level was measured at 3 and 24 h after ERCP,and the incidence of PEP and hyperamylasemia was determined.Comparison of continuous data between the two groups was made by t test,while comparison of rates was made by chi-square test.Results The incidence rates of PEP and hyperamy-lasemia in the test group were 8.1% (30/371)and 13.7% (51/371),respectively,significantly lower than those in the control group (13.8%,26/189;21.2%,40/189),(χ2 =4.47,P=0.034;χ2 =5.06,P=0.024).The serum amylase levels at 3 and 24 h after ERCP in the test group were 215.34 ±304.00 U/L and 199.38 ±273.32 U/L,respectively,significantly lower those in the control group (283.28 ±261.76 U/L and 257.05 ±199.25 U/L)(t=2.61,P=0.01;t=2.57,P=0.01).Conclusion ENBD can effectively re-duce the incidence of PEP and hyperamylasemia in patients with choledocholithiasis.
