单猪尾胰管塑料支架胆管引流在内镜下逆行胰胆管造影术治疗胆总管结石后的疗效观察  

Observation of the curative effect of bile duct drainage with single pigtail pancreatic duct plastic stent after endoscopic retrograde cholangiopancreatography in the treatment of choledocholithiasis

作　　者：王建荣[1] 徐顺福[2] 王潇 彭鹏 李维 全俊 钱丽佳[1] 史健敏 张华 徐晨[1] Wang Jianrong;Xu Shunfu;Wang Xiao(Department of Gastroenterology,Taizhou Fourth People's Hospital,Taizhou 225300,China)

机构地区：[1]泰州市第四人民医院消化内科,225300 [2]江苏省人民医院消化内科

出　　处：《中华保健医学杂志》2021年第6期619-622,共4页Chinese Journal of Health Care and Medicine

基　　金：江苏省泰州市科技支撑计划(社会发展)项目(TS2020323)。

摘　　要：目的探讨内镜下逆行胰胆管造影术(ERCP)术后胆总管结石患者采用单猪尾胰管塑料支架引流(ERBD)的临床效果。方法选取2019年1月~2020年12月泰州市第四人民医院120例行ERCP治疗的胆总管结石患者,随机分为胰管支架组(40例,接受单猪尾胰管塑料支架引流)、鼻胆管组[40例,接受常规鼻胆管引流(ENBD)]、胆管支架组(40例,接受常规胆管引流);观察3组患者引流辅助术前及术后3、7、15 d的疼痛模拟视觉(VAS)评分、耐受度,治疗前后的谷草转氨酶(AST)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、术后并发症及支架脱落时间。结果胰管支架组术后7、15 d的VAS评分均低于鼻胆管组和胆管支架组,耐受度优良率高于鼻胆管组和胆管支架组;胰管支架组支架脱落时间短于胆管支架组,差异均有统计学意义(P<0.05);治疗后胰管支架组、胆管支架AST、TBIL、ALT低于鼻胆管组,差异有统计学意义(P<0.05)。3组术后并发症发生率差异无统计学意义(P>0.05)。结论采用ERBD辅助可有效缓解经ERCP治疗的胆总管结石患者疼痛程度并提高其耐受性,缩短患者支架脱落时间,改善肝功能指标,且安全性较高。Objective To investigate the clinical effect of single pigtail pancreatic duct plastic stent drainage(ERBD)in patients with common bile duct stones after endoscopic retrograde cholangiopancreatography(ERCP).Methods From January 2019 to December 2020,120 patients with common bile duct stones underwent ERCP treatment in our hospital were randomly divided into pancreatic duct stent group(40 cases,receiving single pigtail pancreatic duct plastic stent drainage)and nasobiliary duct group[40 cases,Received conventional nasal bile duct drainage(ENBD)],bile duct stent group(40 cases,received conventional bile duct drainage);observe the three groups of patients with drainage-assisted preoperative and postoperative 3d,7d,15d pain analog vision(VAS)scores,tolerance Acceptance,aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT),postoperative complications,and stent shedding time before and after treatment.Results The VAS scores of the pancreatic duct stent group were lower than those of the nasobiliary duct group and the bile duct stent group at 7 and 15 days after surgery,and the tolerance rate was higher than that of the nasobiliary duct group and the bile duct stent group;the pancreatic duct stent group had shorter stent shedding time than the bile duct stent group,The difference was statistically significant(P<0.05);after treatment,the pancreatic duct stent group,bile duct stent AST,TBIL,and ALT were lower than the nasobiliary duct group,the difference was statistically significant(P<0.05).There was no statistical difference in the incidence of postoperative complications among the three groups(P>0.05).Conclusion Adjuvant ERBD can effectively alleviate the pain of patients with choledocholithiasis treated by ERCP,improve their tolerance,shorten the time of stent shedding in patients,improve liver function indicators,and have high safety.

关 键 词：单猪尾胰管塑料支架 胆管引流 内镜下逆行胰胆管造影术 胆总管结石 术后感染 

分 类 号：R575[医药卫生—消化系统]