CAJ | 학술논문

目的评价儿童及青少年（≤17岁）慢性胰腺炎患儿行经内镜逆行胰胆管造影术（ERCP）诊治的临床价值和安全性。方法回顾性收集2008年1月1日至2014年4月30日上海交通大学医学院附属瑞金医院消化内镜中心行 ERCP 诊治的87例儿童和青少年慢性胰腺炎患儿（2～17岁）的临床资料，按年龄段分成3组，2～6岁（幼儿组，n ＝27）、7～12岁（少年儿童组，n ＝35）、13～17岁（青少年组，n ＝25），统计分析各组内镜诊治情况及并发症发生情况。结果87例患儿共行170例次 ERCP 诊治，ERCP 操作总成功率为99．4％（169／170），均经 ERCP 明确诊断为慢性胰腺炎。ERCP操作成功率幼儿组为97．6％（40／41），少年儿童组为100．0％（72／72），青少年组亦为100．0％（57／57），3组间差异无统计学意义（P ＝0．207）。3组均无出血、穿孔等严重并发症，亦均无操作相关死亡病例，ERCP 术后并发症总发生率幼儿组、少年儿童组和青少年组分别为41．5％（17／41）、25．0％（18／72）和24．6％（14／57），幼儿组的术后并发症总发生率明显高于少年儿童组（P ＝0．039）和青少年组（P ＝0．045）。结论儿童和青少年慢性胰腺炎患儿行 ERCP 诊治是安全和有效的，但年龄小的慢性胰腺炎患儿发生 ERCP 术后并发症的风险可能更高。
목적평개인동급청소년（≤17세）만성이선염환인행경내경역행이담관조영술（ERCP）진치적림상개치화안전성。방법회고성수집2008년1월1일지2014년4월30일상해교통대학의학원부속서금의원소화내경중심행 ERCP 진치적87례인동화청소년만성이선염환인（2～17세）적림상자료，안년령단분성3조，2～6세（유인조，n ＝27）、7～12세（소년인동조，n ＝35）、13～17세（청소년조，n ＝25），통계분석각조내경진치정황급병발증발생정황。결과87례환인공행170례차 ERCP 진치，ERCP 조작총성공솔위99．4％（169／170），균경 ERCP 명학진단위만성이선염。ERCP조작성공솔유인조위97．6％（40／41），소년인동조위100．0％（72／72），청소년조역위100．0％（57／57），3조간차이무통계학의의（P ＝0．207）。3조균무출혈、천공등엄중병발증，역균무조작상관사망병례，ERCP 술후병발증총발생솔유인조、소년인동조화청소년조분별위41．5％（17／41）、25．0％（18／72）화24．6％（14／57），유인조적술후병발증총발생솔명현고우소년인동조（P ＝0．039）화청소년조（P ＝0．045）。결론인동화청소년만성이선염환인행 ERCP 진치시안전화유효적，단년령소적만성이선염환인발생 ERCP 술후병발증적풍험가능경고。
Objective To study the clinical value and the safety of endoscopic retrograde cholangio-pancreatography(ERCP)for chronic pancreatitis in the pediatric population.Methods Clinical data,endo-scopic reports,and radiography of chronic pancreatic patients aged from 2 to 17 years old who underwent ERCP between Jan.1,2008 and Apr.30,2014 at Endoscopy Center of Ruijin Hospital were reviewed.These patients were divided into 3 groups,patients aged from 2 to 6 years old as children group(n =27),patients aged from 7 to 12 years old as juvenile group(n =35)and patients aged from 13 to 17 as adolescent group(n =25). Their clinical data and complications were analyzed by groups.Results A total of 170 ERCP procedures were performed in 87 patients,with the success rate of 99.4%(169 /170).All patients were diagnosed as having chronic pancreatitis by ERCP.Success rates of children group,juvenile group and adolescent group were 97.6%(40 /41),100.0%(72 /72)and 100.0%(57 /57)respectively.There was no statistically significance among the three groups(P =0.207).No serious complications like bleeding or perforation occurred.No proce-dure-related mortality occurred in this study either.The rate of post-ERCP adverse events in children group, juvenile group and adolescent group were 41.5%(17 /41),25.0%(18 /72)and 24.6%(14/57),respective-ly.Children group had more adverse events than the juvenile group(P =0.039)and adolescent group(P =0.045).Conclusion Pediatric ERCP is highly effective in the pediatric population with chronic pancreatitis. The incidence of post ERCP adverse events is higher among the youngest children.