80岁以上高龄患者治疗性ERCP的临床分析  

Clinical efficacy and safety of therapeutic ERCP for patients over 80 years

作　　者：张荣春[1] 秦斌[1] 张林慧[1] 王向平[1] 黄蕊[1] 潘阳林[1] 郭学刚[1] 

机构地区：[1]第四军医大学西京消化病医院,西安710032

出　　处：《中华消化内镜杂志》2011年第1期21-23,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的 研究治疗性ERCP对80岁以上高龄患者的临床疗效及影响因素.方法 回顾性分析2007年8月至2009年8月80例80岁以上ERCP手术患者资料,统计病因及合并症,计算治疗有效率及并发症发生情况.结果 患者最高年龄94岁 51例伴随有心血管疾病等合并症（63.8%） 43例为恶性胆管狭窄（53.8%）.治疗总有效率96.3%（77/80）.术后并发症发生率12.5%（10/80）.胆道恶性肿瘤患者的并发症率18.6%（8/43）,明显高于胆总管结石的5.6%（2/36,P＜0.05） 但是有心肺等系统合并症患者的术后并发症发生率并不比单纯胆胰疾病患者的高（11.8%比13.8%,P＞0.05）.结论 80岁以上高龄不应该作为治疗性ERCP的禁忌证 治疗性ERCP对高龄患者的治疗有效率是肯定的 高龄患者ERCP的并发症发生率较高,但与合并其他系统疾病未必有关联.Objective To investigate the efficacy and complications of therapeutic ERCP for patients over 80 years. Methods Data of 80 patients aging over 80 years, who tnderwent therapeutic ERCP from August 2007 to August 2009 were retrospectively studied. The etiology, complications and therapeutic effects were evaluated. Results A total of 51 patients （63. 8% ） were accompanied by cardiovascular diseases, and 43 patients were diagnosed as having malignant bile duct stricture （53. 8% ）. The overail therapeutic efficacy was 96. 3%. The incidence of post-operative complications was 12. 5% （10/80）. Occurrence of complications in patients with malignant tumors （ 18. 6% ） was significantly higher than that in patients with bile duct stones （5.6% ,P 〈0. 05）. Incidence of complications in those with cardiopulmonary diseases was similar with that in patients without （11.8% vs. 13.8%,P〉0.05）. Conclusion Age more than 80should not be considered as contraindication of ERCP. Therapeutic ERCP is effective in senior patients. Patients with advanced ages shows a relatively high incidence of complication after ERCP, which may not be related to other accompanying diseases.

关 键 词：老年人 80以上 胰胆管造影术 内窥镜逆行 治疗 

分 类 号：R57[医药卫生—消化系统]