三种不同预切法在ERCP困难插管中的临床效果分析  

Clinical analysis of three different precutting methods in difficult intubation of ERCP

作　　者：宋奇锋 高良辉 林师佈 李永强 曾维乾 Song Qifeng;Gao Lianghui;Lin Shibu;Li Yongqiang;Zeng Weiqian(Department of Hepatobiliary Surgery,the First Affliated Hospital of Hainan Medical College,Haikou Hainan Province570100,China)

机构地区：[1]海南医学院第一附属医院肝胆外科,海口570100

出　　处：《中华普外科手术学杂志（电子版）》2022年第5期526-529,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然基金委员会资助项目(81560265)。

摘　　要：目的探讨三种不同预切法在内镜逆行胰胆管造影(ERCP)困难插管中的临床效果。方法回顾性分析2018年1月至2021年6月96例行ERCP困难插管且进一步采用预切法治疗的患者临床资料,根据插管方式的不同分为三组:双导丝法(DGT)为DCT组(n=34例),经胰管乳头括约肌预切开术(TPS)为TPS组(n=32例),DGT+TPS为联合组(n=30例)。应用软件SPSS22.0处理数据。术后并发症情况等计数资料行χ^(2)检验分析;围手术期相关指标等计量资料以(x±s)表示,多组间比较行单因素方差分析,两组间比较行LSD-t检验分析。P<0.05为差异有统计学意义。结果三组手术时间、插管时间及患者术后住院时间比较,差异有统计学意义(P<0.05),其中联合组显著低于DCT组和TPS组(P<0.05);三组插管成功率和患者术后总并发症的发生率比较,差异均无统计学意义(P>0.05)。结论在ERCP困难插管中,DGT联合TPS较单一的运用DGT或TPS能够有效的缩短插管时间,减少手术时间,降低术后并发症发生风险的趋势,从而有利于患者术后康复。Objective To explore the clinical ffects of three different pre cutting methods in difficult intubation of ERCP.MethodsThe clinical data of 96 patients with ERCP difficult intubation and further treated by preresection from January 2018 to June 2021 were analyzed retrospectively.According to diferent intubation methods,they were divided into three groups:The DCT group(n=34 cases),TPS group(n=32 cases),DGT+TPS group(n=30 cases).SPSS 22.0 was used to process the data.Postoperative complications were analyzed by χ^(2) test.Perioperative related indicators and other measurement data were represented by(±s).One-way ANOVA was performed for comparison between multiple groups.LSD-t test was performed for comparison between the two groups.P<0.05 was considered statistically significant.ResultsThere were significant diferences in operation time,intubation time and postoperative hospital stay among the three groups(P<0.05).and the combined group was significantly lower than the DGT group and TPS group(P<0.05).There were no significant differences in the success rate of intubation and incidence of total postoperative complications among the three groups(P>0.05).Conclusion In ERCP dfficult intubation,DCT combined with TPS can effectively shorten intubation time,reduce the operation time,and reduce the risk of postoperative complications compared with the single application of DGT or TPS,thus benefting patients'postoperative recovery.

关 键 词：胰胆管造影术 内窥镜逆行 预切法 困难插管 双导丝法 经胰管乳头括约肌预切开术 

分 类 号：R657.4[医药卫生—外科学]