治疗性ERCP在老年胆胰疾病患者中的临床价值  

Clinical Value of Therapeutic ERCP in Elderly Patients with Cholangiopancreatic Diseases

作　　者：吴汉平[1] 康生朝[1] 张方信[1] 魏红梅[1] 贺月[1] 冯娟[1] 

机构地区：[1]兰州军区兰州总医院消化科

出　　处：《胃肠病学》2010年第1期36-38,共3页Chinese Journal of Gastroenterology

摘　　要：背景：临床上高龄胆胰疾病患者日益增多，而传统手术治疗的风险较大。目的：探讨治疗性ERCP在老年胆胰疾病患者治疗中的临床应用价值。方法：对2006年1月～2009年10月兰州军区兰州总医院诊断为胰胆疾病的343例患者行治疗性ERCP。并按年龄将其分为老年组和非老年组，分析原发疾病、ERCP操作、治疗成功率以及并发症发生率。结果：老年组胆管癌的发生率高于非老年组。除胆管塑料支架置入术（ERBD）外，两组内镜十二指肠乳头括约肌切开术（EST）、胆总管取石术、胆道金属支架置入术（EMBE）、胰管支架置人术（ERPD）、鼻胆管引流术（ENBD）操作频率无明显差异。两组ERCP治疗成功率（82．5％对87．0％）和并发症发生率（3.3％对4．6％）无明显差异。所有并发症经内科保守治疗和内镜下治疗后痊愈。结论：治疗性ERCP是一项安全、有效的治疗技术，尤其适用于老年胆胰疾病患者。其并发症多数可经内科保守治疗联合内镜下治疗治愈。Background： Elderly patients with cholangiopancreatic diseases have been increasing, and the risk of conventional surgical operation is high. Aims： To assess the clinical value of therapeutic ERCP in the treatment of elderly patients with cholangiopancreatic diseases. Methods： A total of 343 patients with cholangiopancreatic diseases were treated with therapeutic ERCP in Lanzhou general hospita] of Chinese PLA from January 2006 to October 2009. Patients were divided into elderly group and non-elderly group according to their age. The primary diseases, ERCP procedures, success rate and complication rate were analyzed. Results： The occurrence rate of bile duct cancer in elderly group was higher than that in non-elderly group. No significant differences of the frequency of endoscopic sphincterotomy （EST）, bile duct stone extraction, endoscopic metal biliary endoprothesis （EMBE）, endoscopic retrograde pancreatic drainage （ERPD）, endoscopic nasobiliary drainage （ENBD） were found between the two groups except endoscopic retrograde bilioduodenal drainage （ERBD）. No significant differences of success rate and complication rate of therapeutic ERCP （82.5% vs. 87.0%, 3.3% vs. 4.6%） were found between the two groups. All complications were cured by conservative treatment and endoscopic treatment. Conclusions： This study demonstrates the effectiveness and safety of therapeutic ERCP in most elderly patients with cholangiopancreatic diseases. Most of ERCP-related complications can be cured by conservative treatment and endoscopic treatment.

关 键 词：胰胆管造影术 内窥镜逆行 胆道疾病 胰腺疾病 老年人 治疗 

分 类 号：R575[医药卫生—消化系统] R576[医药卫生—内科学]