梗阻性黄疸的内镜治疗  

Therapeutic Endoscope in Obstructive Jaundice

作　　者：刘俊[1] 张青[1] 侯晓华[1] 易粹琼[1] 

机构地区：[1]同济医科大学附属协和医院消化内科,武汉430022

出　　处：《临床消化病杂志》1998年第2期56-59,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：对64例经ERCP及B超证实的梗阻性黄疸患者分别进行了乳头括约肌切开,网篮取石,胆总管内机械碎石,胆管气囊扩张,鼻胆引流及胆总管支架管引流.结果:①51例成功地进行了ERCP治疗,成功率为79.7%.②治疗后2周内胆总管直径较治疗前明显缩小(P<0.05);血清总胆红素、ALT及γ-GT较治疗前明显下降(P<0.05～0.01).③胆总管结石患者治疗后1周内腹痛缓解率为92.1%;退热率为100%.④并发症的发生率为7.8%,主要是乳头切开处出血、急性胰腺炎及结石嵌顿,经适当处理很快好转恢复.结果表明:梗阻性黄疸患者ERCP治疗具有患者损伤轻,痛苦小,耐受好及恢复快等优点,应作为单纯胆总管结石,特别是伴有胆囊或股道手术后及高龄患者的首选治疗方法.Sixty four patients with obstructive jaundice were treeated endoscopic sphincterotomy, stone extraction, mechanical lithotripsy, balloon dilatation of bile dact, nasobiliary catheter drainage and stenting of malignant biliary obstruction. The results: ① 51 cases were treated successfully with success rate of 79. 7 % . ② Common bile duct (CBD) diameter significantly reduced posttreatment in two week (P<0.05), and serum bilirubin, ALP and γ-GT were lower than antetreatment (P < 0. 05～ 0. 01). ③ 92.1 % of patients with CBD stone abdominal pain were relieved and 100% fever lower to normal posttreatment in one week. ④Complications occur in about 7.8% of patients, majority were bleeding, acute pancreatitis and stone impaction.

关 键 词：梗阻性黄疸 胆总管 结石 内镜治疗 

分 类 号：R575.05[医药卫生—消化系统]