经内镜乳头括约肌切开术与气囊扩张术治疗胆总管结石临床评价  

Clinical evaluation of endoscopic sphincterotomy and papillary balloon dilatio for removal of common bile duct stones

作　　者：李春明[1] 刘中宏[1] 姜国玲[1] 张兆文[1] 

机构地区：[1]哈尔滨市第一医院消化内科,黑龙江省哈尔滨市150010

出　　处：《世界华人消化杂志》2006年第2期230-233,共4页World Chinese Journal of Digestology

基　　金：哈尔滨市科技局科技攻关项目;No.2004AA9CS196-17

摘　　要：目的:评价经内镜乳头括约肌切开术(EST)和气囊扩张术(EPBD)联合机械碎石(EML)治疗胆总管结石的临床疗效．方法:选取我院住院胆总管结石患者60例,随机分成EST组(n=30)和EPBD组(n=30),分别采用EST和EPBD联合机械碎石进行内镜下取石．观察二组的治愈率,近期并发症、远期并发症．结果:正结果EST组与EPBD组的取石成功率为93．3％和90％．无显著性差异(P>0．05): 两组近期并发症发生率(包括胰腺炎、胆道感染、出血)为30％和13．3％,无显著性差异 (P>0．05);而远期并发症(包括胆道感染、结石复发)26．7％和3.3％,有显著性差异(P<0．05)．结论:EST和EPBD的结石清除率及近期并发症相似,但EPBD远期并发症的发病率较低, 表明EPBD能够在一定程度上保护Oddi括约肌功能。AIM： To evaluate the clinical effect of endoscopic sphincterotomy （EST） and endoscopic papillary balloon dilatation （EPBD） associated with mechanical lithotripsy （EML） in the treatment of common bile duct stones. METHODS： Sixty patients with common bile duct stones were enrolled and randomized to EST （n = 30） and EPBD （n = 30） group. EST or EPBD associated with mechanical lithotripsy were performed in the corresponding group. The success rates for duct clearance as well as the frequency of short-term and long-term complications were evaluated. RESULTS： Duct clearance was achieved in 93.3% patients of EST group and 90% of EPBD group, and there was no significant difference between them （P 〉 0.05）. Short-term complications, including acute pancreatitis, cholangitis and hemorrhage, appeared in 30% and 13.3% patients of EST and EPBD group, respectively, and there was no significant difference between them, either （P 〉 0.05）. However, the rates of long-term complications such as cholangitis and recurrent choledocholithiasis were 26.7% and 3.3% in EST and EPBD group, between which significantly difference existed （P 〈 0.05）. CONCLUSION： EST and EPBD were approximately equal in terms of successful clearance of bile duct stones and short-term complications, but EPBD is more superior in the prevention of long-term complication, indicating that EPBD can protect the papillary function to some extent.

关 键 词：内镜乳头括约肌切开术 气囊扩张术 胆总管结石 并发症 

分 类 号：R657.4[医药卫生—外科学]