内镜鼻胆管引流术治疗经内镜逆行胰胆管造影术后胆管感染及对高淀粉酶血症的影响  

Curative effect of endoscopic nasobiliary drainage on treatment of biliary infections and high amylase after endoscopic retrograde cholangiopancreatography

作　　者：邓衍部 刘有理 贺道兴 王光明 黄志刚 DENG Yan-bu;LIU You-li;HE Dao-xing;WANG Guang-ming;HUANG Zhi-gang(Xuancheng People＇s Hospital, Xuancheng, Anhui 242000, Chin)

机构地区：[1]宣城市人民医院消化内科,安徽宣城242000

出　　处：《中华医院感染学杂志》2018年第3期425-427,443,共4页Chinese Journal of Nosocomiology

基　　金：宣城市科技局基金资助项目(20150016)

摘　　要：目的探讨内镜鼻胆管引流术(ENBD)在治疗内镜逆行胰胆管造影(ERCP)术后胆管感染和高淀粉酶血症的发生情况。方法选择2014年1月-2016年12月医院接诊并经ERCP治疗的180例胆总管结石患者为研究对象,分为试验组和对照组,各90例,对照组患者行ERCP术,相同护理条件和环境下试验组患者ERCP术后行ENBD,进行鼻胆管引流和冲洗,术后3h、24h分别检测患者C-反应蛋白(CRP)和血清淀粉酶含量,分析两组患者术后并发症的发生率,进而评价ERCP术后行ENBD的效果。结果术后3h、24h,试验组患者CRP含量分别为(16.37±8.88)mg/L、(15.49±9.02)mg/L均低于对照组(P<0.001);试验组患者血清淀粉酶含量分别为(110.32±9.63)μ/L和(102.55±47.18)μ/L均低于对照组(P<0.001);术后试验组胆管感染和高淀粉酶血症的发生率分别为4.44%和5.56%,低于对照组(P<0.05)。结论 ERCP后行ENBD术能较好地抑制胆管感染、高淀粉酶血症等相关并发症的发生。OBJECTIVE The evaluate curative effect of endoscopic nasobiliary drainage （ENBD） on treatment of bil- iary infections and high amylase after endoscopic retrograde cholangiopancreatography （ERCP）. METHODS A to- tal of 180 patients with common bile duct stones treated by ERCP in our hospital from Jan. 2014 to Dec. 2016 were selected as the subjects. The samples were randomly divided into experimental group and control group, with 90 patients in each group. Patients of control group were treated with ERCP, and in experimental group were treated with ENBD after ERCP under the same conditions of care and environment. Nasal biliary drainage and irrigation were carried out. After 3 hours and 24 hours, the serum CRP and serum amylase levels were detected, the inci- dence of postoperative complications in the two groups were compared and analyzed, and then the actual effect of ENBD after ERCP was evaluated.RESULTS After 3 hours and 24 hours of operation, the CRP levels of experimen- tal group were （16.37±8.88） mg/L and （15.49±9.02） mg/L, lower than those of control group（P〈0.001）. Thw serum amylase content of experimental group were （110.32 ±9.63） μ/L and （102.55 ±47.18） μ/L, which were lower than （201.87±30.02） μ/L and （257.45 ±38.54） μ/L of control group （P〈0.001）. The incidences of postoperative biliary infection and high amylase in experimental group were 4.44% and 5.56%, which were lower than 23.33% and 17.78% in control group （P〈0.05）. CONCLUSION ERCP is a good method for the treatment of biliary infection and high amylase after ENBD.

关 键 词：内镜鼻胆管引流术 胰胆管造影术 胆管感染 高淀粉酶血症 

分 类 号：R657.4[医药卫生—外科学]