治疗性内镜下逆行胰胆管造影在高龄人群胆系疾病中的应用  

The clinical application of endoscopic retrograde cholangiopancreatography in senile patients with biliary disease

作　　者：麻树人[1] 张宁[1] 赵志峰[1] 赵云峰[1] 杨卓[1] 杨琳[1] 宫照洁[1] 

机构地区：[1]沈阳军区总医院内窥镜科,沈阳110016

出　　处：《中国实用内科杂志》2009年第2期156-158,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的评价治疗性内镜下逆行胰胆管造影(ERCP)在高龄人群胆系疾病患者中应用的临床效果。方法回顾性分析2003年1月至2007年12月沈阳军区总医院经ERCP治疗的70岁以上1863例胆系疾病患者的临床治疗资料。男952例,女911例,年龄70～98岁。术前有明确冠心病史患者1243例,发生过心肌梗死患者397例,有脑梗死后遗症患者242例,脑出血后遗症患者107例,胃大部切除术毕式吻合术后患者296例。结果ER-CP治疗成功1851例,失败12例,术中死亡1例,治疗成功率99.3%。术中诊断胆管结石982例,乳头嵌顿性结石276例,化脓性胆管炎413例,恶性胆管梗阻685例。胆管单支架引流782例,多支架引流231例,金属支架引流248例,鼻胆管引流629例。并发急性胰腺炎17例。结论高龄人群胆系疾病的治疗因病情复杂而难度较大,治疗性ERCP的应用可为其提供了安全有效的治疗方法。Objective To evaluate the value of therapeutic ERCP and to study the feature and announcements of endoscopic treament in senile patients. Methods From 2003 to 2007,1836 patients with biliary disease have been admitted to our unit. All these patients underwent ERCP and were retrospectively analyzed. There were 952 male and three female patients. The age at presentation ranged from 70 to 98 years. 1214 with coronary heart disease, 397 with myocardial infarction,242 with cerbral infarction residual, 107 with brain hemorrhage residual and 296 with Billroth- Ⅰ or Billroth-Ⅱ opation was identified pre-ERCP. Results 1851 therapeutic ERCPs were finished and successful rate was 99. 3%, 12 was failure and one was dead. Of those, 982 had CBD stone, 276 had impacted stone at the papilla, 413 had Suppurative cholangitis,685 had malignancy obstruction of biliary tract. Following procedure had been performed,782 patients underwent drainage with single stent inserted and 231 need two or three stents,248 expandable metal stents ,629 endoscopic nasobiliary drainage（ENBD）. 17 had post-ERCP pancreatitis. Conclusion This case series reports the therapeutic ERCP for senile patients with biliary disease is a safe, convenient and effective procedure.

关 键 词：内镜下逆行胰胆管造影术 胆系疾病 

分 类 号：R5[医药卫生—内科学]