内窥镜逆行胰胆管造影术对不同胃肠道重建术后老年患者胃肠道功能及并发症发生的影响  

Effects of ERCP on gastrointestinal function and complications in elderly patients after different gastrointestinal reconstructions

作　　者：臧蕾[1] 翁昊[2] 赵黎[2] 毛莉艳 Zang Lei;Weng Hao;Zhao Li;Mao Liyan(Department of Digestive Endoscopy,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai,200092,R.P.China;Department of General Surgery,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai,200092,R.P.China)

机构地区：[1]上海交通大学医学院附属新华医院消化内镜诊治部,上海200092 [2]上海交通大学医学院附属新华医院普外科,上海200092

出　　处：《老年医学与保健》2022年第6期1320-1323,共4页Geriatrics & Health Care

摘　　要：目的 比较内窥镜逆行胰胆管造影术对不同胃肠道重建术后老年患者胃肠道功能的影响和并发症发生率。方法 选择2021年1月—2022年6月在上海交通大学医学院附属新华医院行内窥镜逆行胰胆管造影术治疗的胃肠道重建术后的老年患者进行研究。本研究招募胃切除毕Ⅱ式吻合术后患者87例,设为A组;招募胃切除Roux-en-Y吻合术后患者87例,设为B组。观察并比较2组内窥镜逆行胰胆管造影术成功率、术后并发症发生以及胃肠功能恢复情况。结果 2组在ERCP操作成功率上差异无统计学意义(P>0.05)。平均操作时间A组比B组短(P<0.001)。术后住院时间A组比B组长(P<0.05)。2组在胆管炎、出血以及穿孔等并发症发生率上差异无统计学意义(P>0.05)。胃肠道症状评定量表评分(GSRS)A组高于B组(P<0.001)。整体症状量表评分(GOSS)A组高于B组(P<0.05)。结论 Roux-en-Y吻合术后患者和毕Ⅱ式吻合术后患者在内窥镜逆行胰胆管造影术成功率和并发症发生率上无显著差异,但Roux-en-Y吻合术后,胃肠功能恢复更快,患者住院时间更短。对于胃肠道重建的老年患者,在内窥镜逆行胰胆管造影术操作之前,内镜医师应该详细掌握患者既往手术史和重建后解剖结构,选择合适的内镜,提高操作成功率,规避术中和术后并发症的发生。Objective To compare the effects of endoscopic retrograde cholangiopancreatography(ERCP) on gastrointestinal function and the incidence of complications in elderly patients after different gastrointestinal reconstructions. Methods Elderly patients who underwent ERCP after gastrointestinal reconstruction in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2021 to June 2022 were selected for this study.87 patients after Billroth Ⅱ gastrojejunostomy were recruited as group A and 87 patients after Roux-en-Y anastomosis were recruited as group B. The success rate of ERCP, incidence of postoperative complications and gastrointestinal function recovery were compared between the two groups. Results There was no significant difference in the success rate of ERCP between both groups(P=0.224). The average operation time of the group A was shorter than that of the group B(P<0.001). The postoperative hospital stay of the group A was longer than that of the group B(P=0.040). There was no significant difference in the incidence of complications such as cholangitis, bleeding and perforation between both groups(P>0.05). The GSRS score of the group A was higher than that of the group B(P<0.001). The GOSS score of the group A was higher than that of the group B(P<0.001). Conclusion There is no significant difference in the success rate and incidence of complications of ERCP between patients with Roux-en-Y anastomosis and those with Billroth Ⅱ gastrojejunostomy, but gastrointestinal function recovery was faster with Roux-en-Y anastomosis. For elderly patients with gastrointestinal reconstruction, endoscopists should carefully master the patient’s previous surgical history and post-reconstruction anatomical structurebefore ERCP, select the appropriate endoscope, improve the success rate of operation, and avoid the occurrence of intraoperative and postoperative complications.

关 键 词：老年 胃肠道重建 内窥镜逆行胰胆管造影术 并发症 

分 类 号：R656[医药卫生—外科学]