ENBD与EPBD单用或联用的临床效果分析  

Clinical effect analysis of ENBD and EPBD alone or in combination

作　　者：肖耀东 费素娟 XIAO Yaodong;FEI Sujuan(The First Clinical Medical College of Xuzhou Medical University,Xuzhou,Jiangsu,221002,China;Department of Gastroenterology,the Affiliated Hospital of Xuzhou Medical University)

机构地区：[1]徐州医科大学第一临床医学院,江苏徐州221002 [2]徐州医科大学附属医院消化内科

出　　处：《中国中西医结合消化杂志》2022年第6期389-393,401,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:对比经内镜鼻胆管引流术(ENBD)、内镜下乳头括约肌球囊扩张术(EPBD)、ENBD与EPBD联用在内镜逆行胰胆管造影术(ERCP)治疗中的疗效差异。方法:回顾性分析徐州医科大学附属医院在2019年1月—2021年12月行治疗性ERCP成功的住院患者670例,根据手术处理方案将研究对象分成ENBD组、EPBD组及联合组(ENBD+EPBD组)。比较3组手术时间、住院时间、术后3 h及24 h血清淀粉酶情况,统计术后并发症发生情况及发生率、术后症状缓解时间。结果:ENBD+EPBD组手术时间及住院时间与ENBD组、EPBD组进行比较,差异有统计学意义(均P<0.05);EPBD组手术时间及住院时间与ENBD组进行比较,差异有统计学意义(均P<0.05)。在术后3 h及24 h血淀粉酶水平方面,3组对比差异有统计学意义(P<0.05);在术后症状缓解时间上,ENBD+EPBD组术后症状缓解时间短于其余2组,差异有统计学意义(均P<0.05);EPBD组与ENBD组进行比较,EPBD组术后症状缓解时间短于ENBD组,差异有统计学意义(P<0.05)。结论:ENBD与EPBD联用方案安全性好,能更好地降低术后血清淀粉酶指标、缩短住院时间及促进术后症状恢复,并且不会明显增加手术时间。建议在进行ERCP术中采取ENBD联合EPBD的治疗方案。Objective:To compare the therapeutic effects of endoscopic nasobiliary drainage(ENBD)alone,endoscopic sphincter balloon dilation(EPBD)alone,and ENBD combined with EPBD during the trentment with ERCP.Methods:A retrospective analysis was performed on 670 inpatients who were successfully treated with ERCP in the Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021.The patients were grouped according to the surgical treatment plans,for example,only ENBD was performed during ERCP,and the subjects were included in the ENBD group.EPBD was used during ERCP,and subjects were included in the EPBD group.If ERCP was combined with ENBD and EPBD,subjects were included in the combined group(ENBD+EPBD group).The operation time,hospital stay,serum amylase levels at 3 h and 24 h after surgery were compared among the three groups,and the incidence of postoperative complications and postoperative symptom relief time were counted.Results:The operative time and length of hospital stay in ENBD+EPBD group were compared with ENBD group and EPBD group,and the differences were statistically significant(all P<0.05).The operative time and length of hospital stay in the EPBD group were compared with those of the ENBD group,and the differences were statistically significant(all P<0.05).There were statistically significant differences in serum amylase levels at 3 h and 24 h after operation among the three groups(P<0.05).In terms of postoperative symptom relief time,the postoperative symptom relief time of ENBD+EPBD group was shorter than the other two groups,and the difference was statistically significant(all P<0.05).Compared with ENBD group,the postoperative symptom relief time of EPBD group was shorter than that of ENBD group,and the difference was statistically significant(P<0.05).Conclusion:ENBD combined with EPBD has good safety,can better promote the decrease of postoperative serum amylase index,shorten the length of hospital stay and promote the recovery of postoperative symptoms,and will not significantly

关 键 词：鼻胆管引流 乳头球囊扩张 内镜逆行胰胆管造影术 术后胰腺炎 高淀粉酶血症 

分 类 号：R57[医药卫生—消化系统]