MSCT联合ERCP对十二指肠憩室合并胆结石患者术后感染的影响  

Effect of MSCT Combined with ERCP on Postoperative Infection in Patients with Duodenal Diverticulum Complicated with Gallstones

作　　者：路萌 崔雷雷 姜立杰 康洁 LU Meng;CUI Leilei;JIANG Lijie;KANG Jie(The Department of Infection Control,Hengshui People’s Hospital,Hengshui 053000,Hebei,P.R.China;Imaging Center,Hengshui People’s Hospital,Hengshui 053000,Hebei,P.R.China)

机构地区：[1]衡水市人民医院感控处,河北衡水053000 [2]衡水市人民医院影像中心,河北衡水053000

出　　处：《影像科学与光化学》2022年第5期1056-1061,共6页Imaging Science and Photochemistry

基　　金：衡水市科技计划项目(2016014101Z)。

摘　　要：探究基于多层螺旋CT(MSCT)、内镜逆行胰胆管造影术(ERCP)观察对十二指肠憩室合并胆结石患者术后感染控制的影响。选取210例十二指肠憩室合并胆结石患者,随机分为研究组和对照组,各105例。对照组行ERCP内镜取石术,研究组行基于MSCT、ERCP的内镜取石术。结果显示,研究组ERCP插管成功率高于对照组,手术时间、鼻胆管引流时间及术后住院时间短于对照组(P<0.05);两组术后1 d、3 d血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、血糖(Glu)、皮质醇(Cor)水平均高于术前,但研究组均低于对照组(P<0.05);两组术后1 d、3 d血清CD3^(+)、CD4^(+)水平均低于术前,但研究组均高于对照组(P<0.05),两组术后1 d血清CD8^(+)水平均低于术前(P<0.05);研究组切口感染、胆道感染发生率,以及术后6个月、1年复发率均低于对照组(P<0.05)。可见,基于MSCT、ERCP观察行内镜下取石术,能降低十二指肠憩室合并胆结石患者术后感染发生率,有效减少术后复发。This study investigated the effect of multilayer spiral CT(MSCT)-based,endoscopic retrograde cholangiopancreatography(ERCP)observation on postoperative infection control in patients with duodenal diverticulum combined with gallstones.210 patients with duodenal diverticulum combined with gallstones were selected and randomly divided into study group and control group with 105 cases in each group.The control group performed ERCP endoscopic lithotripsy,and the study group performed MSCT and ERCP-based endoscopic lithotripsy.The results showed that the success rate of ERCP cannulation in the study group was higher than those in the control group,and the operation time,nasobiliary drainage time and postoperative hospitalization time were shorter than those in the control group(P<0.05).The serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),blood glucose(Glu),cortisol(Cor)levels at 1 d and 3 d after surgery were lower than those before surgery in both groups,but they were all lower in the study group than in the control group(P<0.05).The serum CD3^(+)and CD4^(+)levels at 1 d and 3 d after surgery were lower than those before surgery in both groups,but they were all higher in the study group than in the control group(P<0.05).The serum CD8^(+)levels at 1 d after surgery were lower than those before surgery in both groups(P<0.05).The incidence of incisional infection,biliary tract infection and recurrence rate at 6 months and 1 year after surgery in the study group were lower than in the control group(P<0.05).It can be seen that endoscopic lithotripsy based on MSCT and ERCP observation can reduce the incidence of postoperative infection and effectively reduce postoperative recurrence in patients with duodenal diverticulum combined with gallstones.

关 键 词：胆结石 十二指肠憩室 内镜逆行胰胆管造影术 多层螺旋CT 感染 

分 类 号：R657.4[医药卫生—外科学]