CAJ | 학술논문

目的：对内镜逆行胰胆管造影( ERCP)用于老年患者诊断及治疗的安全性和耐受性进行回顾性分析。方法回顾性分析2010年1月至2013年12月在我院接受诊断和治疗的1560例患者资料,年龄(71.6±11.4)岁,其中60~69岁1116例,70岁及以上444例,数据包括患者的临床和生化特征,ERCP诊断和并发症。结果对潜在的复合因素进行多变量Logistic回归分析,60~69岁和70岁2组中相关因素的差异未见统计学差异(P=0.039)。老年ERCP检查和治疗中,60~69岁和70岁及以上2组间在成功插管、插管困难和插管失败方面均有一定差异(P <0.05)；2组间胆总管结石发生胆道梗阻和临床诊断无明显差异(P>0.05),但2组间ERCP诊断、术后并发症和急性胰腺炎并发症均有一定差异(P<0.05),70岁及以上的患者耐受性较好,但胆管结石大约是60~69岁患者的2倍(P=0.004)。结论老年患者进行ERCP诊断和治疗是安全的,且耐受性良好,对70岁及以上的老年患者ERCP并发症风险相对更少。
목적：대내경역행이담관조영( ERCP)용우노년환자진단급치료적안전성화내수성진행회고성분석。방법회고성분석2010년1월지2013년12월재아원접수진단화치료적1560례환자자료,년령(71.6±11.4)세,기중60~69세1116례,70세급이상444례,수거포괄환자적림상화생화특정,ERCP진단화병발증。결과대잠재적복합인소진행다변량Logistic회귀분석,60~69세화70세2조중상관인소적차이미견통계학차이(P=0.039)。노년ERCP검사화치료중,60~69세화70세급이상2조간재성공삽관、삽관곤난화삽관실패방면균유일정차이(P <0.05)；2조간담총관결석발생담도경조화림상진단무명현차이(P>0.05),단2조간ERCP진단、술후병발증화급성이선염병발증균유일정차이(P<0.05),70세급이상적환자내수성교호,단담관결석대약시60~69세환자적2배(P=0.004)。결론노년환자진행ERCP진단화치료시안전적,차내수성량호,대70세급이상적노년환자ERCP병발증풍험상대경소。
Objective To analyze the safety and tolerability of endoscopic retrograde cholangiopancreatography ( ERCP) for elderly pa-tients in diagnose and therapy. Methods From Jan. 2010 to Dec. 2013, 1 560 patients were collected in our hospital for diagnosis and treatment, 1 116 cases were 60~69 years old, and the other 444 cases were over 70 years old. Retrospective data including clinical and bio-chemical characteristics, ERCP diagnosis and complications were analyzed. Results Using Logistic regression, the potential factors of com-plex multivariable were analyzed, and there was no statistical difference between the two groups (P=0. 039). The successful intubation, in-tubation difficulties and failed intubation in the examination and the treatment were of significantly difference between the two groups (P<0. 05). There were no significant difference between the two groups in common bile duct stones of bile duct obstruction and clinical di-agnosis (P>0. 05), but the ERCP diagnosis, postoperative complications and complications of acute pancreatitis were of certain difference (P<0. 05). Patients over 70 years old were of better tolerance, but their bile duct stones was about two times than that in patients of 60~69 years old (P=0. 004). Conclusion The results show that ERCP for elderly patients in diagnose and therapy is safe and well tolerated, and there were relatively less complications in patients over 70 years old.