经内镜逆行胰胆管造影术治疗高龄胆总管结石疗效观察及安全性评估  

Effect and safety of ERCP in treating elderly patients with common bile duct calculi

作　　者：张锎[1] 丁辉[1] 李芸[2] 

机构地区：[1]山东省交通医院肝胆内镜外科,山东济南250031 [2]山东省军区门诊部内科,山东济南250031

出　　处：《中国内镜杂志》2015年第3期255-258,共4页China Journal of Endoscopy

基　　金：山东省自然科学基金资助项目(No:Y2007C054)

摘　　要：目的研究经内镜逆行胰胆管造影术(ERCP)治疗高龄胆总管结石疗效观察及安全性。方法将高龄胆总管结石患者纳入研究,根据手术方法不同分为给予治疗性经内镜逆行胰胆管造影术治疗的内镜组和给予胆总管切开取石的外科手术组,比较两组患者的治疗情况、炎症反应以及并发症情况。结果两组取石成功率比较差异无显著性(97.5%VS 95.0%);内镜组患者手术时间(28.6±12.9)min、腹痛缓解时间(1.2±0.3)d、黄疸消退时间(2.1±0.4)d、术后卧床时间(1.4±0.3)d、抗感染治疗时间(1.5±0.3)d、住院时间(6.6±0.4)d、TNF-α(2.1±0.3)μg/L、IL-1(6.4±0.9)μg/L、IL-6(2.8±0.4)μg/L、并发症(1.8%)均明显低于外科手术组(P<0.05)。结论经内镜逆行胰胆管造影术治疗有助于控制创伤、促进恢复、缓解炎症反应、减少并发症,是胆总管结石较理想的治疗方法。【Objective】To study the effect and safety of ERCP in treating elderly patients with common bile duct calculi. 【Methods】Elderly patients with common bile duct calculi were enrolled and divided into observation group received ERCP and control group received common bile duct incision lithotomy. Then treatment condition, inflammation reaction and complications of two groups were compared. 【Results】There was no significant difference of lithotomy success rate between two groups（97.5% VS 95%）; Endoscopy group operation time（28.6 ±12.9） min,abdominal pain remission time, jaundice subsided time, anti infection treatment time, length of hospital stay（1.2 ±0.3）,（2.1±0.4）,（1.4±0.3）,（1.5±0.3）,（6.6±0.4） d, TNF alpha, IL-1, IL-6 levels（2.1 ±0.3）,（6.4±0.9）,（2.8±0.4） ug/L,complications（1.8%） were significantly lower than surgical group（P〈0.05, 0.01）.【Conclusion】ERCP is an ideal therapy in treating elderly patients with common bile duct calculi for it can control wounds, promote recovery, alleviate inflammatory reaction, reduce complications.

关 键 词：胰胆管造影 内镜逆行 切开取石 胆总管结石 炎症反应 

分 类 号：R657.42[医药卫生—外科学]