经内镜逆行性胰胆管造影术联合内镜乳头括约肌切开术治疗胆道疾病的临床效果  

Clinical effect of endoscopic retrograde cholangiopancreatography combined with endoscopic sphincterotomy of papilla in treatment of biliary tract disease

作　　者：周岚 王建祥[1] 彭东曙[1] ZHOU Lan;WANG Jianxiang;PENG Dongshu(Department of Gastroenterology,Chengdu Fifth People′s Hospital,Sichuan Procince,Chengdu611130,China)

机构地区：[1]四川省成都市第五人民医院消化内科

出　　处：《中国医药导报》2019年第35期127-130,共4页China Medical Herald

基　　金：四川省卫生和计划生育委员会科研基金资助项目(1500265)

摘　　要：目的探讨经内镜逆行性胰胆管造影术(ERCP)联合内镜乳头括约肌切开术(EST)治疗胆道疾病的临床效果。方法回顾性分析2017年1月~2018年12月四川省成都市第五人民医院收治的124例胆道疾病患者的临床资料,按照不同的治疗方案将其分为对照组与观察组,每组各62例。对照组采取传统开腹取石手术,观察组采用ERCP联合EST。比较两组临床疗效、临床指标、炎性因子指标水平、并发症发生情况。结果观察组临床总有效率明显高于对照组(P<0.05);观察组腹痛缓解、肠道通气、血清淀粉酶恢复正常、住院时间均明显短于对照组(P<0.05);治疗前,两组肿瘤坏死因子-α、心肺复苏比较,差异无统计学意义(P>0.05),治疗后,两组炎性因子指标水平均降低,且观察组低于对照组(P<0.05);术后观察组并发症总发生率高于对照组(P<0.05)。结论对胆道系统疾病需手术患者采用ERCP+EST方案进行手术治疗术后恢复较快、创伤小等优点,值得临床广泛应用。Objective To investigate the clinical effects of endoscopic retrograde cholangiopa ncreatography(ERCP)combined with endoscopic sphincterotomy(EST)in the treatment of biliary tract disease.Methods The clinical data of 124 patients with biliary tract disease admitted to the Fifth People′s Hospital of Chengdu from January 2017 to December 2018 were retrospectively analyzed.According to different treatment plans,they were divided into control group and observation group,with 62 cases in each group.The control group was treated with conventional calculus removed of laparotomy,and the observation group was treated with ERCP combined with EST.The clinical efficacy,clinical indicators,index levels of inflammatory factor,and complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).In the observation group,abdominal pain relief,intestinal ventilation,serum amylase return to normal,and hospitalization time were significantly shorter than the control group(P<0.05).Before treatment,there was no statistically significant difference between the two groups in tumor necrosis factor-αand cardiopulmonary resuscitation(P>0.05).After treatment,the levels of inflammatory factors were decreased in the two groups,and the observation group was lower than the control group(P<0.05),the incidence of total complications in the observation group was higher than that in the control group(P<0.05).Conclusion For patients with biliary system diseases required surgery,the ERCP+EST program for surgical treatment has the advantages of rapid recovery and small trauma,which is worthy of clinical application.

关 键 词：经内镜逆行性胰胆管造影术 内镜乳头括约肌切开术 胆道疾病 临床疗效 安全性 

分 类 号：R532.205[医药卫生—内科学]