ERCP在老年患者梗阻性黄疸诊断中的应用价值  

Value of ERCP on Diagnosis of Obstructive Jaundice in Elderly Patients

作　　者：徐旭东[1] 吴亚群[1] 刘志苏[2] 孙权[2] 张林[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院普外科,湖北武汉430030 [2]武汉大学中南医院普外科,湖北武汉430071

出　　处：《中国普外基础与临床杂志》2011年第1期55-58,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：湖北省科技攻关计划(项目编号:2003AA301C27)~~

摘　　要：目的探讨内镜逆行性胰胆管造影(ERCP)对老年患者梗阻性黄疸的诊断价值。方法根据年龄将338例梗阻性黄疸患者分为老年组(年龄≥60岁)和非老年组(年龄<60岁),检测2组患者常规ERCP后6、24和48 h血淀粉酶(AMY)和肝功能的变化,对2组患者造影成功率、诊断准确率及并发症发生率进行分析。结果 2组患者ERCP后血AMY、转氨酶(ALT)及总胆红素(TBIL)的差异无统计学意义(P>0.05)。非老年组患者ERCP造影成功率为96.3%(130/135),老年组患者ERCP造影成功率为96.1%(195/203),2组之间差异无统计学意义(P>0.05)。老年组患者ERCP诊断准确率(98.5%,192/195)明显高于非老年组(84.6%,110/130),差异有统计学意义(P<0.05)。非老年组患者ERCP后并发症发生率为14.8%(20/135),老年组患者并发症发生率为17.2%(35/203),2组间差异无统计学意义(P>0.05)。2组患者ERCP后均无死亡病例。结论 ERCP对老年患者梗阻性黄疸是一种安全、有效、准确的诊断方法,具有重要的临床意义。Objective To investigate the diagnostic value of endoscopic retrograde cholangiopancreatography（ERCP） in obstructive jaundice of elderly patients.Methods Totally 338 patients with obstructive jaundice underwent ERCP were divided into elderly group（age ≥60 years old） and non-elderly group（age 60 years old） based on age.The levels of serum amylase（AMY）,ALT,and TBIL in 6,24,and 48 h after ERCP were detected.The success rate of cholangiopancreatography,accuracy rate of diagnosis,and incidence of complications after ERCP in two groups were analyzed.Results The difference of serum AMY,ALT,and TBIL levels of patients in 6,24,and 48 h after ERCP were not significant between two groups（P〉0.05）.The success rate of cholangiopancreatography in non-elderly group was 96.3%（130/135） and in elderly group was 96.1%（195/203）,and no difference was found（P〉0.05）.However,the accuracy rate of diagnosis of ERCP in non-elderly group（84.6%,110/130） was significantly lower than that in elderly group（98.5%,192/195）,P〈0.05.The difference of the incidence of complications was not significant between two groups（14.8%（20/135） vs.17.2%（35/203））,P〉0.05.There was no mortality in two groups patients.Conclusion ERCP is a safe,effective,and accurate method,which is of importance to the diagnosis of obstructive jaundice in elderly patients.

关 键 词：内镜逆行性胰胆管造影 老年患者 梗阻性黄疸 诊断 应用价值 

分 类 号：R657.43[医药卫生—外科学]