内镜逆行胰胆管造影术中使用胰胆直视成像系统联合激光碎石治疗胆总管复杂结石的分析  

Clinical analysis of pancreaticobiliary imaging system of endoscopic retrograde cholangiopancreatography combined with laser lithotripsy in the treatment of complex choledocholithiasis

作　　者：刘姣 朱巧 范建梅[3] LIU Jiao;ZHU Qiao;FAN Jianmei(Department of Anesthesiology,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,Jiangsu,China;Department of Endoscopy Center,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,Jiangsu,China;Department of Endoscopy Center,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu,China)

机构地区：[1]南京医科大学第四附属医院麻醉科,南京210031 [2]南京医科大学第四附属医院内镜中心,南京210031 [3]南京医科大学第二附属医院内镜中心,南京210011

出　　处：《医学研究与战创伤救治》2024年第2期177-180,共4页Journal of Medical Research & Combat Trauma Care

摘　　要：目的探讨经内镜逆行胰胆管造影术中使用胰胆直视成像系统联合激光碎石治疗胆总管复杂结石的治疗效果,及与传统内镜逆行胰胆管造影术的临床疗效获益对比分析。方法回顾性分析2022年1月1日至2023年5月31日南京医科大学第四附属医院内镜中心及南京医科大学第二附属医院内镜中心接受ERCP手术治疗的胆总管复杂结石症患者。分为成像辅助组(胰胆直视成像系统辅助ERCP术,n=24)和对照组(常规ERCP术,n=26)。比较2组手术指标、康复指标、术后并发症发生率、疼痛程度评分标准、焦虑自评量表等临床疗效获益和医疗成本上的差异。结果成像辅助组平均手术时间、平均总住院时间显著低于对照组,且第一次手术成功率显著高于对照组(P<0.05)。成像辅助组切口出血、胆管炎和消化道损伤的发生率显著低于对照组(P<0.05),仅中度疼痛的发生比例低于对照组(P<0.05)。结论胰胆直视成像系统辅助下ERCP术能够给患者带来更好的临床疗效,符合快速康复和精准微创治疗的理念要求。Objective To explore the therapeutic effect of pancreaticobiliary imaging system of endoscopic retrograde cholangiopancreatography combined with laser lithotripsy in the treatment of complex choledocholithiasis,and the comparative analysis of clinical efficacy and benefit compared with traditional endoscopic retrograde cholangiopancreatography.Methods A total of 24 cases of complex choledocholithiasis treated by endoscopic retrograde cholangiopancreatography(ERCP)combined with laser lithotripsis with the assistance of the latest domestic cholangiopancreatography were analyzed in the Endoscopy Center of the Fourth Affiliated Hospital of Nanjing Medical University and the Endoscopy Center of the Second Affiliated Hospital of Nanjing Medical University,who were divided into the study group(ERCP assisted by pancreaticobiliary imaging system,n=24)and the control group(traditional retrograde endoscopic cholangiopancreatography,n=26).The differences of clinical efficacy and medical cost in surgical indexes,rehabilitation indexes,postoperative complication rate,pain degree scoring criteria,SAS anxiety and other clinical efficacy were analyzed.Results In the study group,the average operation time and the average hospital stay were significant lower than those of control group,and there was higher success rate of first operation than that of control group(P<0.05).The incidence of incision bleeding,cholangitis,and gastrointestinal injury in the study group was significantly lower than that of the control group(P<0.05),with only a lower incidence of moderate pain compared to the control group(P<0.05).Conclusion ERCP assisted by pancreaticobiliary imaging system can bring better clinical treatment benefits to patients and meets the concept requirements of rapid recovery and precise minimally invasive treatment.

关 键 词：经内镜逆行胰胆管造影 胰胆直视成像系统 激光碎石 胆总管结石 

分 类 号：R575[医药卫生—消化系统]