ERCP联合胆道微结石检测在特发性急性胰腺炎病因诊断中的临床意义  

Clinical Significance in Etiological Diagnosis of Idiopathic Acute Pancreatitis by ERCP Combined with Biliary Microlithiasis Detection

作　　者：王晖[1] 李治[1] 沈颖[1] 李力[1] 汤旻[1] 李奇[1] 

机构地区：[1]上海同济大学附属杨浦医院普外科,上海200090

出　　处：《现代生物医学进展》2012年第32期6310-6312,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)联合胆道微结石检测对特发性急性胰腺炎(idiopathic acute pancreatitis,IAP)病因诊断的意义;方法:选择我院普外科收治的急性胰腺炎患者178例,其中69例以常规方法检查(对照组),其余109例除行常规检查项目外,对不能明确病因者即IAP行ERCP+胆道微结石(biliarymicrolithiasis,BML)检测寻找病因,比较两种方法对IAP病因学诊断的临床意义。结果:对照组有39例明确病因,占56.52%。研究组常规检查后有65例明确病因,占59.63%。未知病因的患者行ERCP+BML检测,其中35例明确病因,8例ERCP无异常,IAP的总病因诊断率为79.55%(35/44)。对照组通过常规方法检测明确IAP病因12例,占40.00%(12/30),显著低于研究组(x2=12.038,P<0.001)。(P<0.05)。结论:BML是IAP的重要病因之一,ERCP检查联合BML检测可显著提高IAP的病因诊断率。Objective： To investigate the clinical significance of ERCP combined with biliary microlithiasis which were detected in idiopathic acute pancreatitis. Methods： 178 cases of acute pancreatitis in our hospital were collected. Conventional methods were used in 69 cases to check etiology （control group） and in addition to line items of the routine examination, the remaining 109 cases of idiopathic acute pancreatitis （lAP） underwent ERCP and BML detection to find the cause, and they were compared between the two groups in the clinical significance of the etiologic diagnosis of lAP. Results： In the control group, 39 cases had a clear cause, accounting for 56.52%. 65 cases in the study group after a routine examination had a clear cause, accounting for 59.63%. 44 cases of unknown etiology in the study group underwent ERCP ＋ biliary microlithiasis （BML） detection, which eventually had clear causes in 35 cases, no abnormal in 8 cases. Total etiological diagnosis rate of lAP was 75.38%（35/44）. 12 cases had a clear etiological cause, accounting for 40.00%（12/30）, which was significantly lower than the study group （12.038, P 〈0.001）. Conclusion： BML is an important cause of IAP. lAP, which was unde-tected by routine examination, could find the cause by ERCP. If negative, BML detection could be used. These two combinations can sig-nificantly improve the etiological diagnosis rate of lAP.

关 键 词：ERCP 胆道微结石 特发性急性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]