CAJ | 학술논문

目的探讨经内镜逆行胰胆管造影术(ERCP)中置入胰管支架对困难胆管插管患者ERCP术后急性胰腺炎(PEP)的预防效果.方法 120例行ERCP诊疗发生困难胆管插管的患者采用随机数字表法随机分成2组,一组术中置入胰管支架(观察组),另一组未置入(对照组),对比分析2组ERCP术后高淀粉酶血症、PEP的发生率以及术后患者腹痛评分结果.结果观察组发生ERCP术后高淀粉酶血症15例(27.3％),PEP 5例(8.3％),无一例重症PEP,术后患者腹痛评分(3.82±1.48)分;对照组发生ERCP术后高淀粉酶血症18例(30.0％),PEP 14例(23.3％),重症PEP 2例(3.3％),术后患者腹痛评分(4.78±1.93)分.2组ERCP术后高淀粉酶血症发生率比较,差异无统计学意义(P＞0.05);观察组PEP、重症PEP发生率以及术后患者腹痛评分均明显低于对照组,差异均有统计学意义(P＜0.05).结论置入胰管支架可以有效降低胆管插管困难所引起的PEP的风险,并能有效缓解患者术后疼痛,具有较好的临床应用价值.
목적 탐토경내경역행이담관조영술(ERCP)중치입이관지가대곤난담관삽관환자ERCP술후급성이선염(PEP)적예방효과.방법 120례행ERCP진료발생곤난담관삽관적환자채용수궤수자표법수궤분성2조,일조술중치입이관지가(관찰조),령일조미치입(대조조),대비분석2조ERCP술후고정분매혈증、PEP적발생솔이급술후환자복통평분결과.결과 관찰조발생ERCP술후고정분매혈증15례(27.3％),PEP 5례(8.3％),무일례중증PEP,술후환자복통평분(3.82±1.48)분;대조조발생ERCP술후고정분매혈증18례(30.0％),PEP 14례(23.3％),중증PEP 2례(3.3％),술후환자복통평분(4.78±1.93)분.2조ERCP술후고정분매혈증발생솔비교,차이무통계학의의(P＞0.05);관찰조PEP、중증PEP발생솔이급술후환자복통평분균명현저우대조조,차이균유통계학의의(P＜0.05).결론 치입이관지가가이유효강저담관삽관곤난소인기적PEP적풍험,병능유효완해환자술후동통,구유교호적림상응용개치.
Objective To investigate the efficacy of pancreatic duct stent in preventing post-ERCP pancreatitis (PEP) of difficult bile duct cannulation.Methods A total of 120 patients who underwent difficult bile duct cannulation during routine ERCP were randomized to receive pancreatic duct stent placement (S group) or not (NS group),and the incidence of PEP,hyperamylasemia and scores of abdominal pain were analyzed.Results There were 15 cases of hyperamylasemia and 5 cases of PEP occurred in S group,but no severe PEP was observed.The score of abdominal pain was (3.82 ± 1.48) in S group.There were 18cases of hyperamylasemia and 14 cases of PEP occurred,including 2 severe PEP in NS group.The score of abdominal pain was (7.48 ± 1.93) in NS group.There was no significant difference in the incidence of hyperamylasemia between the two groups (P ＞ 0.05).The incidence of PEP,severe PEP and the scores of abdominal pain were lower in the S group (P ＜ 0.05).Conclusion Placement of pancreatic duct stent can reduce the PEP rate of difficult bile duct cannulation and relieve the abdominal pain.