中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2013年
4期
248-252
,共5页
胰胆管造影术,内镜逆行%胰腺炎%引流术
胰膽管造影術,內鏡逆行%胰腺炎%引流術
이담관조영술,내경역행%이선염%인류술
Cholangiopancreatography,endoscopic retrograde%Pancreatitis%Drainage
目的 探讨鼻胰管在预防高危人群内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)中的价值.方法 收集2009年4月至2012年2月PEP高危人群病例共105例,根据ERCP术中情况分为非鼻胰管组58例和鼻胰管组47例.鼻胰管组置入鼻胰管,在X线下导管头端过胰颈即可,非鼻胰管组则根据术中情况选择放置鼻胆管或不放置引流管.采用x2检验和t检验比较分析两组病例ERCP术前、术后临床资料,采用x2检验分析PEP发生率及风险比.结果 在ERCP术后24 h血淀粉酶(t=2.419)、腹痛程度(t3h=2.585,t24h=7.236)及缓解时间(t=4.996)方面,鼻胰管组均优于非鼻胰管组(P均＜0.05),鼻胰管组PEP发生率为6.7％ (3/45),明显较非鼻胰管组(29.3％,17/58)低(x2=8.304,P＜0.01),相对危险度为0.172(95％CI:0.047～0.632,P＜0.01).结论 PEP高危人群术后常规放置鼻胰管,是实用、有效、易于操作的PEP预防方法.
目的 探討鼻胰管在預防高危人群內鏡逆行胰膽管造影(ERCP)術後胰腺炎(PEP)中的價值.方法 收集2009年4月至2012年2月PEP高危人群病例共105例,根據ERCP術中情況分為非鼻胰管組58例和鼻胰管組47例.鼻胰管組置入鼻胰管,在X線下導管頭耑過胰頸即可,非鼻胰管組則根據術中情況選擇放置鼻膽管或不放置引流管.採用x2檢驗和t檢驗比較分析兩組病例ERCP術前、術後臨床資料,採用x2檢驗分析PEP髮生率及風險比.結果 在ERCP術後24 h血澱粉酶(t=2.419)、腹痛程度(t3h=2.585,t24h=7.236)及緩解時間(t=4.996)方麵,鼻胰管組均優于非鼻胰管組(P均＜0.05),鼻胰管組PEP髮生率為6.7％ (3/45),明顯較非鼻胰管組(29.3％,17/58)低(x2=8.304,P＜0.01),相對危險度為0.172(95％CI:0.047～0.632,P＜0.01).結論 PEP高危人群術後常規放置鼻胰管,是實用、有效、易于操作的PEP預防方法.
목적 탐토비이관재예방고위인군내경역행이담관조영(ERCP)술후이선염(PEP)중적개치.방법 수집2009년4월지2012년2월PEP고위인군병례공105례,근거ERCP술중정황분위비비이관조58례화비이관조47례.비이관조치입비이관,재X선하도관두단과이경즉가,비비이관조칙근거술중정황선택방치비담관혹불방치인류관.채용x2검험화t검험비교분석량조병례ERCP술전、술후림상자료,채용x2검험분석PEP발생솔급풍험비.결과 재ERCP술후24 h혈정분매(t=2.419)、복통정도(t3h=2.585,t24h=7.236)급완해시간(t=4.996)방면,비이관조균우우비비이관조(P균＜0.05),비이관조PEP발생솔위6.7％ (3/45),명현교비비이관조(29.3％,17/58)저(x2=8.304,P＜0.01),상대위험도위0.172(95％CI:0.047～0.632,P＜0.01).결론 PEP고위인군술후상규방치비이관,시실용、유효、역우조작적PEP예방방법.
Objective To explore the value of endoscopic nasopancreatic drainage (NPD) in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) in a high-risk population.Methods From April 2009 to February 2012,a total of 105 cases of PEP high risk population were collected and divided into non NPD group (n=58) and NPD group (n=47) according to the situation during the endoscopic retrograde cholangiopancreatography(ERCP) operation.NPD was placed in NPD group,the head of the drainage passed the neck of pancreas under X-ray.Nasobiliary drainage or no drainage was assigned to the group of non NPD group according to the situation during operation.x2 test and t-test were performed for comparing and analyzing the clinical data before and post operation,the incidence and risk ratio of PEP between the two groups.Results Twenty-four hours after ERCP,the mean level of serum amylase at 24 h (t=2.419),the degree of abdominal pain (t3h=2.585,t24h=7.236) and relief time (t=4.996) of NPD group were better than those of non NPD group (all P＜0.05).The incidence of PEP in NPD group was 6.7％(3/45) and non NPD group was 29.3 ％ (17/58),the incidence of PEP in the NPD group was significantly lower than that in the non NPD group (x2 =8.304,P＜0.01),and the relative risk was 0.172 (95％CI:0.047 to 0.632,P＜0.01).Conclusion The regular placement of endoscopic NPD is a practical,effective and easy way to prevent PEP in high risk population.
