引入微处理器控制的电外科学后,括约肌切开术后出血:新技术是否带来变化  

Post-sphincterotomy bleeding after the introduction of microprocessor-controlled electrosurgery: Does the new technology make the difference?

作　　者：Perini R.F. Sadurski R. Cotton P.B. 赵天智 

机构地区：[1]107 Cougarstone Court SW, Calgary, Alta. T3H 4R5, Canada Dr.

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2005年第6期40-41,共2页Core Journals in Gastroenterology

摘　　要：Bleeding as a complication of endoscopic sphincterotomy is influenced by several factors. The objective of this study was to compare rates of bleeding after sphincterotomy performed with two different electrosurgical current generators (Valleylab SSE2L and ERBE ICC200). A total of 6179 consecutive reports of ERCP were analyzed to compare the frequency of endoscopically and clinically evident bleeding after sphincterotomy when using the Valleylab SSE2L generator (from February 1994 to November 1997) and the ERBE ICC200 generator (from December 1997 to September 2000). Relevant risk factors were assessed by univariate analysis and significant predictors were included in a multiple logistic regression model. A total of 2711 sphincterotomies were performed in 2309 patients (1749 biliary, 962 pancreatic). Endoscopically observed bleeding occurred in 68 patients (5.5%) in the ValleyLab group and 13 (1.2%) in the ERBE group. The ValleyLab generator was independently associated with an increase in endoscopically observed bleeding (OR 4.02: 95%CI[2.13, 7.61], p < 0.001). There was no significant difference in clinically evident bleeding between the two groups. Use of the microprocessor-controlled ERBE electrosurgical generator for endoscopic sphincterotomy was associated with a significantly lower frequency of endoscopically observed bleeding but not clinically evident bleeding.Bleeding as a complication of endoscopic sphincterotomy is influenced by several factors. The objective of this study was to compare rates of bleeding after sphincterotomy performed with two different electrosurgical current generators (Valleylab SSE2L and ERBE ICC200). A total of 6179 consecutive reports of ERCP were analyzed to compare the frequency of endoscopically and clinically evident bleeding after sphincterotomy when using the Valleylab SSE2L generator (from February 1994 to November 1997) and the ERBE ICC200 generator (from December 1997 to September 2000). Relevant risk factors were assessed by univariate analysis and significant predictors were included in a multiple logistic regression model. A total of 2711 sphincterotomies were performed in 2309 patients (1749 biliary, 962 pancreatic). Endoscopically observed bleeding occurred in 68 patients (5.5%) in the ValleyLab group and 13 (1.2%) in the ERBE group. The ValleyLab generator was independently associated with an increase in endoscopically observed bleeding (OR 4.02: 95%CI[2.13, 7.61], p < 0.001). There was no significant difference in clinically evident bleeding between the two groups. Use of the microprocessor-controlled ERBE electrosurgical generator for endoscopic sphincterotomy was associated with a significantly lower frequency of endoscopically observed bleeding but not clinically evident bleeding.

关 键 词：括约肌切开术 微处理器控制 胆管疾病 ERBE 模型评估 内镜观察 单变量分析 显著性差异 

分 类 号：R657.4[医药卫生—外科学]