急性重症胆管炎的内镜治疗  

The endoscopic treatment of acute and intensive cholangitis

作　　者：赵加应[1] 沈强[1] 陈涌湘[1] 黄陶承[1] 顾学鸿[1] 

机构地区：[1]复旦大学附属上海市第五人民医院,上海200240

出　　处：《肝胆胰外科杂志》2002年第3期145-147,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 :探讨内镜治疗急性重症胆管炎 (ACST)的疗效和方法。方法 :回顾分析我院经内镜治疗的31例ACST病人治疗前后胆总管直径、血清总胆红素、GPT、ALP、γ GT、血白细胞数以及腹痛等指标变化。结果 :31例病人均耐受内镜治疗 ,93.5 % (2 9/31)症状缓解 ,87.1% (2 7/31)治愈 ,2例内镜治疗失败转手术 ,无 1例死亡。有 4例发生高淀粉酶血症 ,其中 1例发生急性胰腺炎 ,2例出血 ,均治愈 ,无 1例肠穿孔。结论 :内镜治疗ACST是一种安全、有效、创伤小、恢复快、残石率低、适应证广、并发症少的治疗方法。提倡尽早行内镜治疗ACST。Objective:To discuss the effectiveness and method of using endoscope to treat acute and intensive cholangitis.Methods:To analyze retrospectively 31 cases of acute and intensive cholangitis treated by using endoscope in our hospital by analyzing their changes in diameter of choledochus,total bilirubin,GPT,AKP,γ GT,WBC and index of abdominal pain before and after the treatment.Results:All the 31 cases underwent endoscope treatment,of which 29(93.6%) cases were alleviated,27(87.1%) cases were cured,2 cases failed and were shifted to an operation. No one died. Four cases were complicated with high anaylase,one of which was complicated with acute pancreatitis,and 2 cases with hemorrhage. All were cured. No complication of intestinal perforation.Conclusion:Endoscopic treatment is a safe and effective way with little trauma,quick recovery,low residual calculi rate,broad indication and low complication rate. We suggest early use of endoscope in the treatment.

关 键 词：乳头切开术 鼻胆管引流 急性重症胆管炎 内镜 治疗 

分 类 号：R657.45[医药卫生—外科学]