熊去氧胆酸预防内镜下逆行胰胆管造影取石术术后结石复发的效果观察  

Preventive effect of ursodeoxycholic acid on recurrence of stones after endoscopic retrograde cholangiopancreatography for stone removal

作　　者：李妮 张健康[2] LI Ni;ZHANG Jian-kang(The First Clinical Medical College of Shanxi Medical University,Taiyuan 030000,China;Department of Gastroenterology,the First Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第一临床医学院,太原市030000 [2]山西医科大学第一医院消化内科,太原市030000

出　　处：《广西医学》2020年第19期2530-2532,2538,共4页Guangxi Medical Journal

摘　　要：目的观察熊去氧胆酸(UDCA)预防内镜下逆行胰胆管造影(ERCP)取石术术后患者结石复发的效果。方法回顾性分析140例行ERCP取石术治疗的胆总管结石患者的临床资料。按照术后UDCA服用情况,将140例患者分为未服用组23例,短期服用组(<1个月)75例和长期服用组(>9个月)42例。术后随访2年,比较3组患者结石复发情况,并观察服用UDCA的不良反应发生情况。结果未服用组、短期服用组、长期服用组的结石复发率分别为21.74%(5/23)、18.67%(14/75)、2.38%(1/42),其中长期服用组结石复发率均低于未服用组及短期服用组(均P<0.05),而未服用组及短期服用组结石复发率差异无统计学意义(P>0.05)。服用UDCA患者均未发生严重不良反应。结论胆总管结石患者ERCP取石术术后长期服用UDCA可降低结石复发率,且安全性较高。Objective To observe the preventive effect of ursodeoxycholic acid(UDCA)on recurrence of stones after endoscopic retrograde cholangiopancreatography(ERCP)for stone removal.Methods The clinical data of 140 patients with choledocholithiasis treated by ERCP for stone removal were retrospectively analyzed.According to the postoperative use of UDCA,the 140 patients were divided into non administration group(23 cases),short-term administration group(duration of medication shorter than one month,75 cases)and long-term administration group(duration of medication more than nine months,42 cases).After two years of postoperative follow-up,the recurrence of stones in the three groups was compared,and the incidence of adverse reactions due to UDCA administration was observed.Results The recurrence rates of stones in the non administration group,short-term administration group and long-term administration group were 21.74%(5/23),18.67%(14/75)and 2.38%(1/42),respectively,wherein the recurrence rate of stones in the long-term administration group was lower than that in the non administration group or the short-term administration group(all P<0.05),but there was no statistically significant difference in recurrence rate of stones between the non administration group and the short-term administration group(P>0.05).None of patients administered UDCA suffered from serious adverse reactions.Conclusion After ERCP for stone removal,long-term use of UDCA can reduce the recurrence rate of stones with higher safety in patients with choledocholithiasis.

关 键 词：熊去氧胆酸 内镜下逆行胰胆管造影取石术 胆总管结石 复发率 不良反应 

分 类 号：R575.624[医药卫生—消化系统] R657.42[医药卫生—内科学]