中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
16期
2443-2446
,共4页
内镜逆行膜胆管造影术%鼻胆管引流%胰胆管支架置入%并发症%防治
內鏡逆行膜膽管造影術%鼻膽管引流%胰膽管支架置入%併髮癥%防治
내경역행막담관조영술%비담관인류%이담관지가치입%병발증%방치
Endoscopic retiograde cholangiopancreatgraphy%Nasal biliary drainage%Pancreatic or bile duct stent%Complication%Prevent and treat
目的：分析治疗性内镜逆行胰胆管造影术（ERCP）临床应用及术后并发症的发生情况。方法回顾性分析1482例治疗性 ERCP 患者的临床资料。结果1482例中，468例于内镜治疗后行鼻胆管引流，532例行胰或胆管支架置入术，482例患者未行鼻胆管引流和胰胆管支架置入术。在行鼻胆管引流的患者468例中，胆道结石396例，胆总管扩张36例，胆总管囊肿8例，缩窄性乳头炎6例，胆总管炎性狭窄18例，硬化性胆管炎2例，自身免疫性胰腺炎2例；行胰胆管支架置入术患者532例中，胆道恶性梗阻483例，胆总管结石13例，胰管结石28例，硬化性胆管炎3例，胆总管炎性狭窄5例；未行鼻胆管或内支架引流的患者482例中，胆总管结石385例，胆总管扩张36例，胆总管炎性狭窄38例，缩窄性乳头炎11例，胰管结石9例，胆总管囊肿3例。未行鼻胆管引流或内支架植入组急性胰腺炎、急性胆管炎的发生率分别为4．4％、2．6％，均明显高于鼻胆管引流组（1．5％、0．6％，P ＜0．05）及内支架植入组（1．7％、0．8％，P ＜0．05）；而十二指肠或胆道穿孔及上消化道出血的发生率分别是0．2％、1．2％，与鼻胆管引流组（0．2％、0．6％）及内支架植入组（0.4％、0．8％）差异无统计学意义（P ＞0．05）；鼻胆管引流组与内支架植入组的4种并发症发生率差异均无统计学意义。结论内镜下鼻胆管引流或胰胆管支架置入能有效防治治疗性 ERCP 的部分并发症。
目的：分析治療性內鏡逆行胰膽管造影術（ERCP）臨床應用及術後併髮癥的髮生情況。方法迴顧性分析1482例治療性 ERCP 患者的臨床資料。結果1482例中，468例于內鏡治療後行鼻膽管引流，532例行胰或膽管支架置入術，482例患者未行鼻膽管引流和胰膽管支架置入術。在行鼻膽管引流的患者468例中，膽道結石396例，膽總管擴張36例，膽總管囊腫8例，縮窄性乳頭炎6例，膽總管炎性狹窄18例，硬化性膽管炎2例，自身免疫性胰腺炎2例；行胰膽管支架置入術患者532例中，膽道噁性梗阻483例，膽總管結石13例，胰管結石28例，硬化性膽管炎3例，膽總管炎性狹窄5例；未行鼻膽管或內支架引流的患者482例中，膽總管結石385例，膽總管擴張36例，膽總管炎性狹窄38例，縮窄性乳頭炎11例，胰管結石9例，膽總管囊腫3例。未行鼻膽管引流或內支架植入組急性胰腺炎、急性膽管炎的髮生率分彆為4．4％、2．6％，均明顯高于鼻膽管引流組（1．5％、0．6％，P ＜0．05）及內支架植入組（1．7％、0．8％，P ＜0．05）；而十二指腸或膽道穿孔及上消化道齣血的髮生率分彆是0．2％、1．2％，與鼻膽管引流組（0．2％、0．6％）及內支架植入組（0.4％、0．8％）差異無統計學意義（P ＞0．05）；鼻膽管引流組與內支架植入組的4種併髮癥髮生率差異均無統計學意義。結論內鏡下鼻膽管引流或胰膽管支架置入能有效防治治療性 ERCP 的部分併髮癥。
목적：분석치료성내경역행이담관조영술（ERCP）림상응용급술후병발증적발생정황。방법회고성분석1482례치료성 ERCP 환자적림상자료。결과1482례중，468례우내경치료후행비담관인류，532례행이혹담관지가치입술，482례환자미행비담관인류화이담관지가치입술。재행비담관인류적환자468례중，담도결석396례，담총관확장36례，담총관낭종8례，축착성유두염6례，담총관염성협착18례，경화성담관염2례，자신면역성이선염2례；행이담관지가치입술환자532례중，담도악성경조483례，담총관결석13례，이관결석28례，경화성담관염3례，담총관염성협착5례；미행비담관혹내지가인류적환자482례중，담총관결석385례，담총관확장36례，담총관염성협착38례，축착성유두염11례，이관결석9례，담총관낭종3례。미행비담관인류혹내지가식입조급성이선염、급성담관염적발생솔분별위4．4％、2．6％，균명현고우비담관인류조（1．5％、0．6％，P ＜0．05）급내지가식입조（1．7％、0．8％，P ＜0．05）；이십이지장혹담도천공급상소화도출혈적발생솔분별시0．2％、1．2％，여비담관인류조（0．2％、0．6％）급내지가식입조（0.4％、0．8％）차이무통계학의의（P ＞0．05）；비담관인류조여내지가식입조적4충병발증발생솔차이균무통계학의의。결론내경하비담관인류혹이담관지가치입능유효방치치료성 ERCP 적부분병발증。
Objective To analyze the clinical observation and incidences of complications of therapeutic post-endoscopic retrograde cholangiopancreatography (ERCP).Methods The clinical information of 1 482 cases of therapeutic ERCP was analyzed retrospectively.Results Among them,468 cases had nasal biliary drainage,532 cases had pancreatic or bile duct stent after endoscopic procedure and the other 482 case hadn't.For the drainage group, there were 396 cases of biliary stone,36 cases of simple dilatation of common bile duct,8 cases of biliary cyst,6 cases of strictured papilla,18 cases of inflammatory stricture of common bile duct,2 cases of sclerosing cholangitis and 2 cases of autoimmune pancreatitis.For the pancreatic or bile duct stent group,there were 483 cases of malignant bili-ary obstruction,13 cases of biliary stone,28 cases of pancreatic duct stone,3 cases of sclerosing cholangitis and 5 cases of inflammatory stricture of common bile duct.And there were 385 cases of biliary stone,36 cases of simple dilatation of common bile duct,38 cases of inflammatory stricture of common bile duct,11 cases of strictured papilla, 9 cases of pancreatic duct stone and 3 cases of biliary cyst for un -drainage group.The incidences of acute pancreati-tis and acute cholangitis (4.4%,2.6%)were higher in un -drainage group than the nasal biliary drainage group (1.5%,0.6%,P <0.05)or the stent group(1.7%,0.8%,P <0.05).The incidences of duodenum or biliary tract perforation and upper gastrointestinal hemorrhage(0.2%,1.2%)were not significantly different compared with the nasal biliary drainage group(0.2%,0.6%,P >0.05)and the stent group(0.4%,0.8%,P >0.05).The incidences of 4 kinds of complications were not significantly different between the nasal biliary drainage group and the stent group.Conclusion Endoscopic nasal biliary drainage or stent can prevent and treat some of therapeutic ERCP com-plications effectively.
