ERCP治疗老龄胆总管结石临床疗效观察  

ERCP analysis of clinical efficacy of the treatment of aging of common bile duct stones

作　　者：连卫玲 聂占国[2] 雷婷[2] 热合曼[2] 游云[2] 张新[2] 刘国伟[2] 代忠明[2] 

机构地区：[1]石河子大学医学院,新疆石河子市832000 [2]兰州军区乌鲁木齐总医院,乌鲁木齐市830000

出　　处：《临床合理用药杂志》2015年第26期16-18,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨内镜下逆行胰胆管造影（ERCP）治疗老龄胆总管结石患者的临床疗效。方法回顾性总结医院2009年1月-2013年1月行ERCP治疗的〉60岁胆总管结石患者,评价ERCP治疗老龄胆总管结石患者的安全性及有效性。结果 967例老龄胆总管结石患者成功治疗957例,其中7例因心肺功能差或无法配合未实施ERCP,3例术中穿孔转外科手术治疗。首次插管成功率96.5%,手术成功率98.9%。结石1次取净864例（90%）,2次取净结石48例（5%）,〉2次取净结石26例（2.7%）,放置胆道支架22例（2.3%）。ERCP后总胆红素（64.5±105.9）μmol/L;术后直接胆红素（36.7±59.8）μmol/L;术后谷丙转氨酶（61.8±71.2）U/L;术后谷草转氨酶（50.3±61）U/L。术后肝功明显好转（P〈0.05）。术后2h血淀粉酶（113±161）U/L,无统计学差异（P〉0.05）,24h血淀粉酶（126.9±219.9）U/L,与术前相比有统计学差异（P〈0.05）。术后腹痛、寒战、发热、黄疸均有不同程度的减轻或消失。〉60岁胆总管结石患者术后平均住院天数3～7d,与〈60岁年龄相比无统计学意义（P〉0.05）。并发症36例,并发症发生率3.7%,其中急性胰腺炎11例,急性胆管炎12例,出血10例,穿孔3例,经对症治疗后均治愈出院,无1例死亡。结论 ERCP治疗老龄胆总管结石临床疗效显著,对老龄患者是安全、有效的治疗方式。Objective To investigate the effect of endoscopic retrograde cholangiopancreatography （ERCP） clinical efficacy in the treatment of elderly patients with choledocholithiasis. Methods 967 Cases who receive ERCP therapy from Jan- uary 2009 to January 2013 were studied retrospective , evaluate the safety and efficacy of therapeutic ERCP in patients 60 years of age and older with Common bile duct calculi. Results 967 Cases of elderly patients with common bile duct stones treated successfully with 957 cases, Among them 7 cases because of poor cardiopulmonary function or unable to cope with the non im- plementation of ERCP,3 cases of intraoperative perforation of surgical operation treatment, for the first time, the success rate of intubation was 96.5% ,the successful rate of operation was 98.9%. The stones were removed completely one time in 864 cases （90%） ,two times take net calculi in 48 cases （5%） ,more than two times take net calculi in 26 cases （2.7%） ,22 cases were placed biliary stent （2.3%）. Total bilirubin after ERCP：64.5 ± 105.91μmol/1; postoperative bilirubin direct： 36.7 ± 59.8 μmol/1; postoperative ALT： 61.8 ± 71.2 U/L; postoperative aspartate aminotransferase ： 50.3 ± 61 U/L; postoperative liver function improved significantly （P 〈 0.05 ）. Postoperative 2h blood amylase was 113 ~ 161U/L. showed no significant differ- ence （P 〉 0.05 ）,24h blood amylase was 126.9 ：t： 219.9U/L,there was significant difference compared with before operation （P 〈 0.05 ）. Postoperative pain, chills, fever, jaundice have different degrees of ease or disappear. The average length of 60 years old of above of common bile duct stones in patients with postoperative days 3 - 7days, compared with the age below 60 years old with no statistical significance （P 〉 0.05 ）. Complications Occurred in 36 cases, the complication rate was 3.7 % , in- cluding 11 cases of acute pancreatitis, 12 cases of acute cholangitis, 10 cases of bleeding, perforation in 3 cases, after symptom- ati

关 键 词：内镜下逆行胰胆管造影 老龄 胆总管结石 疗效 

分 类 号：R657.4[医药卫生—外科学]