鼻胆管引流术预防经内镜逆行胰胆管造影术后感染的临床分析  

Clinical effect of endoscopic nasal biliary drainage on prevention of infections after endoscopic retrograde cholangiopancreatography

作　　者：倪猛[1] 樊宏伟[1] 高改云[1] 

机构地区：[1]南阳市中心医院消化一科,河南南阳473000

出　　处：《中华医院感染学杂志》2014年第1期146-147,共2页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(0511041900)

摘　　要：目的探讨鼻胆管引流术(ENBD)预防经内镜逆行胰胆管造影术(ERCP)后胆管感染的临床效果,旨在改善ERCP手术的临床预后。方法将2011年8月-2013年1月86例行ERCP术的病例随机分成观察组46例和对照组40例,观察组术后行ENBD,对照组术后未行ENBD,比较两组ERCP术后胆管感染情况,采用SPSS13.0软件进行统计分析。结果观察组和对照组患者ERCP术后胆管感染分别为2、4例,感染率分别为4.3%、10.0%,组间比较差异有统计学意义(P<0.05);观察组中2例单纯性胆管炎药物保守治疗后痊愈;对照组中单纯性胆管炎1例对症处理后好转,3例急性重症胆管炎(ACST)分别行开腹胆道引流术、经皮肝穿刺胆道引流术,其中2例治疗无效并发多器官功能衰竭(MOF)死亡。结论 ENBD能有效预防ERCP术后胆管感染,对于存在ERCP术后胆管感染危险因素的手术患者尤其必要。OBJECTIVE To investigate the clinical effect of endoscopic nasal biliary drainage（ENBD）on prevention of infections after the endoscopic retrograde cholangiopancreatography（ERCP）so as to improve the clinical outcome of post-ERCP.METHODS Totally 86patients who underwent ERCP from Aug 2011 to Jan 2013 were randomly divided into the observation group with 46cases and the control group with 40cases,then the observation group was treated with the post-ERCP,while the control group was not treated with the post-ERCP,the incidence of the post-ERCP biliary tract infections was compared between the two groups,and the statistical analysis was performed with the use of SPSS13.0 software.RESULTS The post-ERCP biliary tract infections occurred in 2（4.3%）cases of the observation group and 4（10.0%）cases of the control group,the difference between the two groups was significant（P0.05）;2cases of simple cholangitis in the observation group were cured after conservative drug therapy,and 1case of simple cholangitis in the control group was improved after symptomatic treatment.Of 3cases of acute cholangitis of severe type who respectively underwent the biliary drainage or percutaneous transhepatic biliary drainage,2case died from multiple organ failure（MOF）.CONCLUSIONENBD can effectively prevent post-ERCP biliary tract infections,which is in particularly important for the patients at high risk of postERCP infections.

关 键 词：鼻胆管引流术 经内镜逆行胰胆管造影术 胆管感染 

分 类 号：R619.3[医药卫生—外科学]