中华胃肠内镜电子杂志
中華胃腸內鏡電子雜誌
중화위장내경전자잡지
Chinese Journal of Gastrointestinal Endoscopy （Electronic Edition）
2015年
1期
28-30
,共3页
杨娇楠%王修齐%丁辉%韩双印%李修龄%杨玉秀
楊嬌楠%王脩齊%丁輝%韓雙印%李脩齡%楊玉秀
양교남%왕수제%정휘%한쌍인%리수령%양옥수
内镜逆行胰胆管造影术%十二指肠乳头括约肌切开术%球囊扩张%内窥镜检查%手术后并发症%手术后出血
內鏡逆行胰膽管造影術%十二指腸乳頭括約肌切開術%毬囊擴張%內窺鏡檢查%手術後併髮癥%手術後齣血
내경역행이담관조영술%십이지장유두괄약기절개술%구낭확장%내규경검사%수술후병발증%수술후출혈
Endoscopic retrograde cholangiopancreatography%Endoscopic sphincterectomy%Balloon dilatation%Endoscopy%Postoperative complications%Postoperative hemorrhage
目的 探讨内镜引导逆行胰胆管造影术( ERCP)后十二指肠乳头迟发型大出血的影响因素及内镜下治疗策略. 方法 回顾性分析2008年3月至2014年12月经郑州大学人民医院(河南省人民医院)消化科行ERCP诊疗的1571例患者的临床及内镜诊疗资料. 结果 十二指肠乳头切开(EST)组术后迟发型大出血率(5/1034,0.48%)略高于球囊扩张组(0/479,0),但无显著差异(0.88%vs 0,P=0.066). 5例大出血患者均在内镜下成功止血,其中1 例止血钳止血,2 例氩离子凝固术( APC)止血,2例肾上腺素注射止血,1例注射止血成功后再次出血,采用APC止血成功. 结论 APC是ERCP术后十二指肠乳头迟发型大出血止血的有效措施,操作简单且安全,采用球囊扩张可能降低十二指肠乳头迟发型大出血的发生率,但本研究样本量较少,还需要多中心大样本研究进一步验证.
目的 探討內鏡引導逆行胰膽管造影術( ERCP)後十二指腸乳頭遲髮型大齣血的影響因素及內鏡下治療策略. 方法 迴顧性分析2008年3月至2014年12月經鄭州大學人民醫院(河南省人民醫院)消化科行ERCP診療的1571例患者的臨床及內鏡診療資料. 結果 十二指腸乳頭切開(EST)組術後遲髮型大齣血率(5/1034,0.48%)略高于毬囊擴張組(0/479,0),但無顯著差異(0.88%vs 0,P=0.066). 5例大齣血患者均在內鏡下成功止血,其中1 例止血鉗止血,2 例氬離子凝固術( APC)止血,2例腎上腺素註射止血,1例註射止血成功後再次齣血,採用APC止血成功. 結論 APC是ERCP術後十二指腸乳頭遲髮型大齣血止血的有效措施,操作簡單且安全,採用毬囊擴張可能降低十二指腸乳頭遲髮型大齣血的髮生率,但本研究樣本量較少,還需要多中心大樣本研究進一步驗證.
목적 탐토내경인도역행이담관조영술( ERCP)후십이지장유두지발형대출혈적영향인소급내경하치료책략. 방법 회고성분석2008년3월지2014년12월경정주대학인민의원(하남성인민의원)소화과행ERCP진료적1571례환자적림상급내경진료자료. 결과 십이지장유두절개(EST)조술후지발형대출혈솔(5/1034,0.48%)략고우구낭확장조(0/479,0),단무현저차이(0.88%vs 0,P=0.066). 5례대출혈환자균재내경하성공지혈,기중1 례지혈겸지혈,2 례아리자응고술( APC)지혈,2례신상선소주사지혈,1례주사지혈성공후재차출혈,채용APC지혈성공. 결론 APC시ERCP술후십이지장유두지발형대출혈지혈적유효조시,조작간단차안전,채용구낭확장가능강저십이지장유두지발형대출혈적발생솔,단본연구양본량교소,환수요다중심대양본연구진일보험증.
Objective To investigate risk factors and endoscopic treatment for delayed hemorrhage of duodenal papilla following endoscopic retrograde cholangiopancreatography ( ERCP ) . Methods A retrospective analysis was performed on the clinical and endoscopic data of 1571 patients undergoing ERCP in Zhengzhou University Affiliated People′s Hospital from March 2008 to December 2014 .Results The incidence of delayed hemorrhage following ERCP in EST group (5/1034) was higher than that in the ballon dilatation group(0/479), and the difference was not statistically significant (0.88% vs 0%,P=0.066). Five cases of patients underwent endoscopic hemostasis successfully .One case accepted hemostat , 2 cases accepted APC , and 2 cases accepted adrenaline injection , one of which accepted APC for the hemorrhage after operation again .Conclusions APC is an effective measure to control the hemorrhage ,which is simple and safe.Balloon dilatation may reduce the risk of delayed hemorrhage of duodenal papilla .But the sample size of this study is small , and it also needs to be further verified .
