3cm与5cm胰管支架预防ERCP术后胰腺炎发生的疗效比较  

Comparison of the efficacy of 3 cm or 5 cm pancreatic stents in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis

作　　者：张乙川[1] 李劲[1] 王俊[1] 徐杰[1] 杨茂辉[1] 齐锐[1] 

机构地区：[1]攀枝花学院附属医院肝胆胰脾外科,四川攀枝花617000

出　　处：《重庆医学》2016年第24期3388-3390,共3页Chongqing medicine

摘　　要：目的探讨预防性放置3cm或5cm胰管支架预防内镜下逆行胰胆管造影术(ERCP)手术后胰腺炎的临床疗效。方法选取2013年6月至2015年6月该院行ERCP治疗患者220例进行前瞻性研究,随机将入组患者分为3cm支架组和5cm支架组,评价其治疗疗效。结果 178例患者成功置入支架,支架放置成功率为81.0%。其中3cm支架组支架置入成功率为83.0%,5cm支架组支架置入成功率为79.0%。意向性分析结果显示3cm支架组和5cm支架组不良反应发生率分别为6.4%和11.0%,两组比较,差异无统计学意义(P>0.05)。而符合方案集分别显示3cm支架组胰腺炎发生率为3.3%,明显低于5cm支架组的10.3%,两组比较,差异有统计学意义(P<0.05)。3cm支架组和5cm支架组支架移位中位时间分别为3d和5d,两组比较,差异有统计学意义(P<0.01)。结论短支架在预防ERCP术后胰腺炎方面优于长支架,由此建议ERCP术后使用3cm的无凸缘支架。Objective To compare the prophylactic efficacy for post-endoscopic retrograde cholangiopancreatography（ERCP） pancreatitis prevention between 3 cm and 5 cm pancreatic stent. Methods A total of 220 consecutive patients in our hospital from June 2013 to June 2015 requiring therapeutic ERCP were prospectively enrolled and randomized to undergo prophylactic insertion with 3 or 5 cm pancreatic stent, and its therapeutic efficacy was evaluate. Results A total of 178 patients were implanted stent suc- cessfully,and the success rate was 81.0%. The success rate of 3 cm stent was 83.0% ,and that of 5 cm stent was 79.0%. Intention- to-treat analysis revealed that the adverse reaction rates of 3 cm and 5 cm stent group were 6.4% and 11.0%, respectively,and the difference was not statistically significant （P〉0. 05）. However, the pancreatitis incidence rate of 3 cm s tent group 3.3% （3/91） was significantly lower than 5 cm stent group 10.3 %, and the difference was statistically significant （P〈0.05）. The migration me- dian time of 3 cm Stent group and 5 cm stent group were 3 days and 5 days, respectively, and the difference was statistically signifi- cant （P〈0.05）. Conclusion The result revealed a superiority of 3-cm stems compared with 5 cm stents for prophylactic pancreatic stent. On the basis of the result of the present study,we recommend using 3 cm unflanged stent.

关 键 词：胰管支架 胰胆管造影术 内窥镜逆行 胰腺炎 支架长度 移位时间 不良反应 

分 类 号：R576[医药卫生—消化系统]