EST+ENBD对急性梗阻性化脓性胆管炎的治疗意义  

Treatment significance of EST +ENBD for acute obstructive suppurative cholangitis

作　　者：唐辉蓉[1] 张家骅[1] 廖陈[1] 吴雪松[1] 马俊[1] 杨彦龙[1] 

机构地区：[1]昆明医科大学第二附属医院,云南昆明650101

出　　处：《中国当代医药》2013年第23期62-63,共2页China Modern Medicine

摘　　要：目的探讨经内镜十二指肠乳头括约肌切开术(EST)和内镜下鼻胆管引流术(ENBD)对急性梗阻性化脓性胆管炎(AOSC)的治疗意义。方法对53例AOSC患者进行EST和ENBD,观察术前、术后相关指标的变化,评估其疗效。结果术后临床症状及相关实验室指标较术前均明显改善,21例一次性取石成功;11例第1次未取完结石,病情稳定后1周再次取石成功;另21例也赢得宝贵时间,将急诊手术变为择期手术,行开腹胆总管切开取石、T管引流术成功。结论 EST+ENBD手术操作简单、创伤小、术后并发症少、恢复快,可作为AOSC首选的治疗方式。Objective To investigate the treatment significance of endoscopic sphincterotomy（EST） and endoscopic naso-biliary drainage（ENBD） for acute obstructive suppurative cholangitis（AOSC）.Methods Fifty-three patients with AOSC received EST and ENBD.The postoperative changes of relevant indicators were observed and the curative effects were evaluated.Results All the clinical symptoms and relevant laboratory indicators after surgery improved significantly compared to before surgery.Twenty-one patients had successful one-time stone removal and 11 patients did not,whose stones were removed successfully 1 week after the patient’s condition stabilizes.The other 21 patients gained valuable time,for whom emergency surgery was changed into elective surgery;The stones were removed successfully by open choledocholithotomy and T tube drainage.Conclusion EST＋ENBD surgery is simple and minimally invasive,causes few complications and facilitates fast recovery,which can be used as the preferred treatment for AOSC.

关 键 词：急性梗阻性化脓性胆管炎 胆总管结石 经内镜十二指肠乳头括约肌切开术 内镜下鼻胆管引流术 

分 类 号：R575.7[医药卫生—消化系统]