ERCP治疗胆管末端良性病变并胆管炎的疗效及复发因素分析  

Analysis of the efficacy and recurrence factors of ERCP in the treatment of benign lesions of the bile duct with cholangitis

作　　者：周亚柏 张开光[1] 王成 王桂周 Zhou Yabo;Zhang Kaiguang;Wang Cheng(Dept of Gastroenterology,The First Affiliated Hospital of University of Science and Technology,Hefei 230000;Dept of Gastroenterology,Fuyang people's Hospital,Fuyang 236000)

机构地区：[1]安徽省合肥市中科大一附院消化内科,合肥230000 [2]阜阳市人民医院消化内科,阜阳236000

出　　处：《安徽医科大学学报》2020年第9期1412-1415,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省2016年公益性技术应用研究联动计划项目(编号:1604f0804016)

摘　　要：目的探究内镜下逆行胆胰管造影术(ERCP)治疗胆管末端良性病变合并胆管炎的疗效,分析术后复发胆管炎的影响因素。方法回顾性选取胆管末端良性病变合并胆管炎患者86例,患者均接受ERCP治疗。统计患者术后2周实验室检查指标及主要症状改善情况、并发症发生率;随访1年,统计胆管炎复发率,分析术后复发胆管炎的影响因素。结果术后2周,86例患者中总胆红素(TB)改善占75.58%,谷丙转氨酶(ALT)改善占81.40%,白细胞下降占87.21%,腹痛缓解占88.37%。共发生并发症10例(11.6%),其中胰腺炎3例(3.5%),胆道感染3例(3.5%),高淀粉酶血症3例(3.5%),低氧血症1例(1.2%);无死亡病例及穿孔、消化道出血发生。术后复发胆管炎患者有18例(20.93%);多因素Logistic分析显示,年龄>65岁、并憩室、操作时间>45min以及合并胆囊结石是胆管末端良性病变合并胆管炎患者术后复发胆管炎的危险因素(P<0.05)。结论 ERCP治疗胆管末端良性病变合并胆管炎近期疗效确切,并发症少;而年龄>65岁、并憩室、操作时间>45 min,合并胆囊结石的患者术后更易复发胆管炎。Objective To investigate the efficacy of endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of benign bile duct lesions with cholangitis,and to analyze the influencing factors of postoperative recur-rent cholangitis.Methods Eighty-six patients with benign bile duct benign lesions and cholangitis were retrospec-tively selected.All patients received ERCP.The patients'laboratory examination index and improvement of main symptoms and complication rate were counted 2 weeks after operation.The recurrence rate of cholangitis was coun-ted 1 year after follow-up,and the influencing factors of postoperative recurrent cholangitis were analyzed.Results In 2 weeks after surgery,the improvement of total bilirubin(TB),alanine aminotransferase(ALT),leucopenia and abdominal pain relief accounted for 75.58%,81.40%,87.21%and 88.37%respectively.There were 10 cases of complications(11.6%),including 3 cases of pancreatitis(3.5%),3 cases of biliary tract infection(3.5%),3 cases of hyperamylasemia(3.5%),and 1 case of hypoxemia(1.2%);no death and perforation,gas-trointestinal bleeding occurred.There were 18 patients(20.93%)with recurrent cholangitis after operation.Multi-variate logistic analysis showed that age>65 years,diverticulum,operation time>45 min and with gallbladder stone were recurrent bile ducts in patients with benign bile duct lesions and cholangitis.Risk factors for inflamma-tion(P<0.05).Conclusion ERCP is effective in the treatment of benign lesions of the bile duct with cholangitis.The complications are less.The patients with age>65 years old,diverticulum and operation time>45 min,and with gallbladder stone are more likely to relapse cholangitis after surgery.

关 键 词：胆管末端良性病变 胆管炎 内镜下逆行胆胰管造影术 复发 影响因素 

分 类 号：R575.7[医药卫生—消化系统]