中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
Chinese Journal of General Surgery
2015年
11期
903-905
,共3页
吕云霄%程云霄%许跃明%杜为兵%王宾%何江
呂雲霄%程雲霄%許躍明%杜為兵%王賓%何江
려운소%정운소%허약명%두위병%왕빈%하강
十二指肠疾病%胆管炎%降钙素原%十二指肠镜检查
十二指腸疾病%膽管炎%降鈣素原%十二指腸鏡檢查
십이지장질병%담관염%강개소원%십이지장경검사
Duodenal disease%Cholanglitis%Procalcitonin%Duodenoscopy
目的 探讨十二指肠乳头旁憩室(juxtapapillary duodenal diverticula,JPDD)在不同程度急性结石性胆管炎中的临床意义.方法 回顾性分析2011年1月至2013年12月间东阳市人民医院收治并施行十二指肠镜治疗的急性结石性胆管炎病例488例,分析其临床资料.结果 本组488例患者JPDD检出率在Ⅰ级、Ⅱ级、Ⅲ级结石性胆管炎患者中分别为2.87％、6.15％、4.10％;Ⅲ级胆管炎JPDD检出率比Ⅱ级、Ⅰ级胆管炎JPDD检出率高(x2=4.486,P=0.034;x2=14.686,P＜0.001);JPDD组Ⅲ级胆管炎血浆降钙素原(procalcitonin,PCT)值高于Ⅱ级、Ⅰ级胆管炎血浆PCT值(t=10.420 9,P＜0.001;t =4.8704,P＜0.001).有JPDD组插管失败例数及术后24 h淀粉酶水平高于无JPDD组(x2=36.95,P＜0.001;t=8.29,P＜0.001).结论 JPDD检出率与患者年龄、胆管炎严重程度有关,可能影响其血浆PCT值;JPDD可能会增加增加十二指肠镜插管失败率及术后24 h淀粉酶水平.
目的 探討十二指腸乳頭徬憩室(juxtapapillary duodenal diverticula,JPDD)在不同程度急性結石性膽管炎中的臨床意義.方法 迴顧性分析2011年1月至2013年12月間東暘市人民醫院收治併施行十二指腸鏡治療的急性結石性膽管炎病例488例,分析其臨床資料.結果 本組488例患者JPDD檢齣率在Ⅰ級、Ⅱ級、Ⅲ級結石性膽管炎患者中分彆為2.87％、6.15％、4.10％;Ⅲ級膽管炎JPDD檢齣率比Ⅱ級、Ⅰ級膽管炎JPDD檢齣率高(x2=4.486,P=0.034;x2=14.686,P＜0.001);JPDD組Ⅲ級膽管炎血漿降鈣素原(procalcitonin,PCT)值高于Ⅱ級、Ⅰ級膽管炎血漿PCT值(t=10.420 9,P＜0.001;t =4.8704,P＜0.001).有JPDD組插管失敗例數及術後24 h澱粉酶水平高于無JPDD組(x2=36.95,P＜0.001;t=8.29,P＜0.001).結論 JPDD檢齣率與患者年齡、膽管炎嚴重程度有關,可能影響其血漿PCT值;JPDD可能會增加增加十二指腸鏡插管失敗率及術後24 h澱粉酶水平.
목적 탐토십이지장유두방게실(juxtapapillary duodenal diverticula,JPDD)재불동정도급성결석성담관염중적림상의의.방법 회고성분석2011년1월지2013년12월간동양시인민의원수치병시행십이지장경치료적급성결석성담관염병례488례,분석기림상자료.결과 본조488례환자JPDD검출솔재Ⅰ급、Ⅱ급、Ⅲ급결석성담관염환자중분별위2.87％、6.15％、4.10％;Ⅲ급담관염JPDD검출솔비Ⅱ급、Ⅰ급담관염JPDD검출솔고(x2=4.486,P=0.034;x2=14.686,P＜0.001);JPDD조Ⅲ급담관염혈장강개소원(procalcitonin,PCT)치고우Ⅱ급、Ⅰ급담관염혈장PCT치(t=10.420 9,P＜0.001;t =4.8704,P＜0.001).유JPDD조삽관실패례수급술후24 h정분매수평고우무JPDD조(x2=36.95,P＜0.001;t=8.29,P＜0.001).결론 JPDD검출솔여환자년령、담관염엄중정도유관,가능영향기혈장PCT치;JPDD가능회증가증가십이지장경삽관실패솔급술후24 h정분매수평.
Objective To evaluate the clinical significance of juxtapaillary duodenal diverticula (JPDD) in patients of acute calculous cholangitis (AC) with different severity grade.Methods A retrospective analysis was carried out for 488 AC cases of different severity from January 2011 to December 2013 who underwent duodenoscopy in Dongyang People's Hospital.Results Of the 488 patients, the JPDD was found in 2.87％, 6.15％ and 4.10％ in patients with mild, moderate and severe AC, respectively.The prevalence of JPDD in severe AC were significantly higher in the moderate and mild AC (x2 =4.486, P =0.034;x2 =14.686, P ＜ 0.001);Procalcitonin (PCT) concentrations in severe AC of JPDD were significantly higher in moderate and mild AC of JPDD (t =10.420 9, P ＜ 0.001;t =4.870 4, P ＜ 0.001).The cannulation failure rate and the amylase were significantly higher in JPDD patients compares to patients without JPDD (x2 =36.95, P ＜ 0.001;t =8.29, P ＜ 0.001).Conclusions JPDD detection rate increases with aging and seems to be associated with acute cholangitis (AC) with different severity grade and PCT concentration.JPDD predicts a higher cannulation failure rate and the amylase level after duodenoscopy.
