快速交换系统在胆管取石中的应用研究  

The study on the application of rapid exchange biliary system for calculus of bile duct removed cases.

作　　者：令狐恩强[1] 柴宁莉[2] 杜红[1] 王向东[1] 孟江云[1] 

机构地区：[1]中国人民解放军总医院消化内科,北京100853 [2]陕西省人民医院消化科,陕西西安710068

出　　处：《中国实用内科杂志》2007年第18期1462-1464,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的评价快速交换(RX)系统在内镜下逆行胰胆管造影(ERCP)治疗胆管结石中的应用价值。方法将2005年11月至2007年4月中国人民解放军总医院收治的154例胆管结石患者按结石和临床情况随机分为两组,其中一组应用传统器械(76例),另一组应用RX系统(78例),分别记录并统计分析两组在取石过程中的导丝脱出率、器械交换时间、网篮及球囊插入胆管的难易程度、一次取石成功率和术后相关并发症发生情况。结果RX组较传统组明显降低了导丝脱出率(%)(2.2±1.4对9.5±2.8,P<0.01)和加快了器械交换时间(s)(124±41对302±69,P<0.01);而且,与传统组比较,RX系统的网篮(P<0.01)及球囊(P<0.05)插入胆管也相对容易;但两组的一次结石取净率差异无显著性意义,RX组和传统组分别为88.46%(69/78)和81.58%(62/76);另外两组均有个别患者发生了术中乳头少量出血和术后胰腺炎。结论RX系统缩短了治疗时间,方便了胆管取石操作,提高了治疗效率。Objective To evaluate the application of RX rapid exchange biliary system in（endoscopic retrograde cholangiopancreatography, ERCP） treatment for patients with bile duct stone. Methods 154 patients were divided into traditional devices group（76 cases）or RX system group（78 cases）according to the size of bile duct stone and state of patients randomizly, then guide wire loss rates, catheter/guide wire exchange times and easy degree of buskets and ballons inserted to bile duct was recorded respectively during procedure, all parameters was analyized by Chi-square methods or t test. Resuits The guide wire loss rates （ % ） of RX group was obviously lower than that of traditional devices group （2. 2 ± 1.4 vs 9. 5 ± 2.8, P 〈 0. 01 ）, the catheter/guide wire exchange times （s） of RX group was signficantly shorter than that of traditional devices group（ 124 ±41 vs 302 ±69,P 〈0.01）and it waseasier to inserting buskets and ballons to bile duct in RX group than that of traditional devices group （P 〈 0.01 ;P 〈 0. 05 ）, but it was no difference of complete calculus retrivieal rates one times between two groups （P 〉 0. 05）. Conclusion RX system is shorten the time and convenience the operation in ERCP for treating patients with common bile duct stone, as well as improve the therapy efficiency.

关 键 词：胆管结石 快速交换系统 逆行胰胆管造影 

分 类 号：R5[医药卫生—内科学]