亲水导丝辅助内镜逆行胆管插管的效果评价  

Clinical evaluation of endoscopic retrograde common bile duct cannulation guided by hydrophilic guide wire

作　　者：宋玲玲[1] 张诚 李立[1] 马跃峰[1] 杨玉龙 SONG Lingling;ZHANG Cheng;LI Li;MA Yuefeng;YANG Yulong(Department of Biliary Minimally Invasive Surgery,Affilated Zhongshan Hospital of Dalian University,Dalian,Liaoning 116001,China;Cholelithiasis Center,Tongji University Affiliated Shanghai East Hospital,Shanghai 200120,China)

机构地区：[1]大连大学附属中山医院胆石病微创外科,辽宁大连116001 [2]同济大学附属东方医院胆石病中心,上海200120

出　　处：《中国医学工程》2020年第4期55-58,共4页China Medical Engineering

摘　　要：目的评价亲水导丝辅助内镜逆行胆道插管的疗效。方法将333例患者随机分成观察组(亲水导丝)和对照组(斑马导丝),比较两组插管次数、插管时间、5 min内插管成功率,以及术后胰腺炎(PEP)、高淀粉酶血症(HA)、迟发性出血(DH)发生率。结果观察组171例,对照组162例。观察组插管次数及插管时间均低于对照组,差异具有统计学意义(P1=0.000、P2=0.000);观察组插管成功率高于对照组,差异具有统计学意义(P=0.000)。观察组胰管造影率及胰管支架置入率低于对照组,而手术操作时间却高于对照组,差异均无统计学意义(P1=0.814、P2=0.562、P3=0.576);观察组术后PEP、HA及DH发生率均低于对照组,差异均无统计学意义(P1=0.332、P2=0.072、P3=0.155)。结论内镜逆行胆管插管术中使用亲水导丝可缩短插管时间,提高插管成功率,减少胰管造影及胰管支架置入率,但是并不会缩短手术操作时间或降低并发症发生率。【Objective】 To evaluate the efficacy of endoscopic retrograde common bile duct cannulation guided by hydrophilic guide wire.【Methods】A total of 333 patients were randomly divided into observation group(hydrophilic guide wire)and control group(zebra guide wire). The average cannulation number, cannulation time, success rate in 5 min and the incidence of postoperative pancreatitis(PEP), hyperamylasemia(HA) and delayed hemorrhage(DH) were compared between the two groups.【Results】There were 171 cases in the observation group and 162 cases in the control group. The average cannulation number and cannulation time in the observation group were lower than those in the control group, and the differences were statistically significant(P1=0.000, P2=0.000). The success rate in the observation group was higher than that in the control group, and the difference was statistically significant(P=0.000). The pancreatic duct angiography rate and pancreatic stent placement rate in the observation group were lower than those in the control group, and the operation time was higher than that in the control group, but there were no significant differences between the two groups(P1=0.814, P2=0.562, P3=0.576). The incidences of PEP, HA and DH in the observation group were lower than those in the control group, but there were no statistical differences(P1=0.332, P2=0.072, P3=0.155).【Conclusion】The use of hydrophilic guide wire in endoscopic retrograde common bile duct cannulation can shorten the cannulation time, improve the cannulation success rate, reduce the rate of pancreatic duct angiography and pancreatic stent placement, but it does not reduce operation time and the incidence of complications.

关 键 词：内镜逆行胰胆管造影术 亲水导丝 胰腺炎 并发症 

分 类 号：R657.3[医药卫生—外科学] R575.7[医药卫生—临床医学]