ENBD与ERBD治疗急性梗阻性胆管炎56例  

Treatment of acute obstructive cholangitis by ENBD and ERBD: Analysis of 56 cases

作　　者：谢宏民[1] 杨新魁[1] 李佳璇[1] 

机构地区：[1]广东医学院附属陈星海医院消化内科,广东省中山市528415

出　　处：《世界华人消化杂志》2014年第4期578-582,共5页World Chinese Journal of Digestology

摘　　要：目的:内镜下胆汁引流通常有鼻胆管引流(endoscopic nasobiliary drainage,ENBD)和内镜置入塑料胆管支架引流术(endoscopic retrograde biliary drainage,ERBD)两种方法.我们比较了ENBD和ERBD治疗本院56例急性梗阻性胆管炎的治疗效果.方法:共筛选出56例急性梗阻性胆管炎患者随机接受急诊ENBD(n=28)或ERBD组(n=28).分别比较临床结果和并发症.结果:ENBD组与ERBD相比较,所有患者成功手术.两组患者临床表现是相似的(P>0.1),腹痛、发热、黄疸症状发生率术后12、24 h、3、7 d对比无明显差异(P>0.1),并发症发生率两组相似(P>0.1).然而,ERBD堵塞的发病率显著高于鼻胆管引流(P=0.015).结论:两种胆管引流(ERBD和ENBD)是急性梗阻性胆管炎患者有效的治疗方法,但ERBD阻塞率更高,如果患者脓性胆汁较多,而且肝功能较差的情况下,则应该选择ENBD行外引流.AIM： To compare the safety and effectiveness of endoscopic nasobiliary drainage （ENBD） versus endoscopic retrograde biliary drainage （ERBD） in patients with acute obstructive cholangitis. METHODS： Fifty-six selected patients with acute obstructive cholangitis were randomized to undergo emergency endoscopic biliary drain- age by ENBD （n = 28） or ERBD （n = 28）. Clinical outcomes and adverse events were compared between the two groups. RESULTS： Baseline patient data were similar between the two groups. Endoscopic biliary drainage was successful in all patients. Compli- cation rates were similar between the ENBD and ERBD groups. There was no significant differ- ence in the incidence of abdominal pain, fever, or jaundice at 12, 24 h, 3 d, and 7 d postopera- tively. However, the incidence rate of blockagewas statistically higher in the ERBD group than in the ENBD group （P = 0.015）. CONCLUSION： Endoscopic biliary decompres- sion is an effective treatment for patients with acute obstructive cholangitis. In contrast to other studies, we found an increased rate of blockage in patients undergoing ERBD. If the patient has more purulent bile or poor liver function, ENBD should be used.

关 键 词：内镜置入塑料胆管支架引流术 鼻胆管引流 急性梗阻性胆管炎 

分 类 号：R657.4[医药卫生—外科学]