CAJ | 학술논문

目的：观察双导丝插管技术在ERCP选择性胆管插管困难中的应用效果及护理配合要点。方法：选择行ERCP治疗的患者，对常规导丝引导切开刀选择性胆总管插管失败且导丝3次进入胰管者，保留胰管导丝，再次用第2根导丝引导切开刀进行选择性胆总管插管，并比较双导丝法与常规插管方法的成功率及术后胰腺炎发生率。结果：73例治疗性ERCP中，常规插管成功51例，22例为插管困难性ERCP，对导丝3次进入胰管者采用双导丝技术行胆管深插管有16例，成功15例，两组间差异有统计学意义(P<0.05)；在常规插管方法患者中有2例术后发生胰腺炎，在双导丝方法中也有2例发生术后胰腺炎，两组间差异无统计学意义(P>0.05)。结论：双导丝插管是常规胆总管深插管失败后比较可靠的一种补偿方法，可以提高困难性ERCP诊治的成功率，术中娴熟的护理配合技巧是保证双导丝插管法行困难ERCP成功的关键。
목적：관찰쌍도사삽관기술재ERCP선택성담관삽관곤난중적응용효과급호리배합요점。방법：선택행ERCP치료적환자，대상규도사인도절개도선택성담총관삽관실패차도사3차진입이관자，보류이관도사，재차용제2근도사인도절개도진행선택성담총관삽관，병비교쌍도사법여상규삽관방법적성공솔급술후이선염발생솔。결과：73례치료성ERCP중，상규삽관성공51례，22례위삽관곤난성ERCP，대도사3차진입이관자채용쌍도사기술행담관심삽관유16례，성공15례，량조간차이유통계학의의(P<0.05)；재상규삽관방법환자중유2례술후발생이선염，재쌍도사방법중야유2례발생술후이선염，량조간차이무통계학의의(P>0.05)。결론：쌍도사삽관시상규담총관심삽관실패후비교가고적일충보상방법，가이제고곤난성ERCP진치적성공솔，술중한숙적호리배합기교시보증쌍도사삽관법행곤난ERCP성공적관건。
Objective:To observe the effect of the double-guidewire technique in difficult biliary cannulation and it's nursing methods.Method:a catheter, pre-inserted with a guidewire was used for standard binary canulation,pa-tients who failed standard binary canulation within 10 min and guidewire were inserted into pancreatic ducts for 3 times, were defined difficult binary canulation.Then a guide was left in pancreatic duct.catheter, pre-inserted with another guidewire, was used for the second binary canulation.And compare the successful rate and post ERCP pan-creatitis rate of the two canulation methods.Result:of the total 73 patients,51 patients were successful by standard canulation,and 22 patient were difficult canulation cases.In 22 difficult patients,15 cases were canulated successful-ly by double-guidewire technique.The successful rate of canulation were significant different between two groups (P<0.05).Differe nce of the post ERCP pancreatitis rate between two groups was not significant (P>0.05).Conclusion:double-guidewire technique can improve the successful rate of ERCP canulation when standard canulation failed.