针状刀开窗术在急性梗阻化脓性胆管炎患者中的应用效果  

Application effect of needle knife fenestration in patients with acute obstructive suppurative cholangitis

作　　者：张小宾 焦振东 赵少琪 惠鹏 金上博 ZHANG Xiaobin;JIAO Zhendong;ZHAO Shaoqi;HUI Peng;JIN Shangbo(Hepatobiliary,Pancreatic and Spleen Surgery Department,Baoji People's Hospital,Baoji 721000,China;Obstetrics Department,Baoji People's Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市人民医院肝胆胰脾外科,陕西宝鸡721000 [2]宝鸡市人民医院产科,陕西宝鸡721000

出　　处：《临床医学研究与实践》2024年第24期62-65,共4页Clinical Research and Practice

摘　　要：目的比较针状刀开窗术与弓状刀预切开术在内镜逆行性胰胆管造影术(ERCP)治疗急性梗阻化脓性胆管炎(AOSC)患者的临床效果。方法回顾性分析2016年12月至2021年12月宝鸡市人民医院肝胆胰脾外科收治的42例AOSC行ERCP遭遇困难插管患者的临床资料,将18例行针状刀开窗术患者纳入针状刀组,24例行弓状刀预切开术患者纳入弓状刀组。比较两组的术中相关指标(插管成功率、插管时间、手术时间)、临床相关指标(治疗费用、住院天数)、术后并发症发生情况。结果AOSC患者插管总成功率为92.86%。两组的插管成功率比较,差异无统计学意义(P>0.05);针状刀组的插管时间、手术时间短于弓状刀组,差异具有统计学意义(P<0.05)。针状刀组的治疗费用少于弓状刀组,差异具有统计学意义(P<0.05);针状刀组的住院天数虽短于弓状刀组,但差异无统计学意义(P>0.05)。两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论针状刀开窗术在AOSC行ERCP遭遇困难插管患者中的应用效果显著,值得推广。Objective To compare the clinical effects of needle knife fenestration and arcuate knife pre-cut operation in patients with acute obstructive suppurative cholangitis(AOSC)treated by endoscopic retrograde cholangiopancreatography(ERCP).Methods The clinical data of 42 patients with AOSC who underwent difficult intubation during ERCP admitted in the hepatobiliary,pancreatic and spleen surgery department of Baoji People's Hospital from December 2016 to December 2021 were retrospectively analyzed.Eighteen patients who underwent needle knife fenestration were included in needle knife group,and 24 patients who underwent arcuate knife pre-cut operation were included in arcuate knife group.The intraoperative related indicators(success rate of intubation,intubation time and operation time),clinical related indicators(treatment cost,hospitalization days)and postoperative complications were compared between the two groups.Results The total success rate of intubation in AOSC patients was 92.86%.There was no significant difference in the success rate of intubation between the two groups(P>0.05);the intubation time and operation time of the needle knife group were shorter than those of the arcuate knife group,and the differences were statistically significant(P<0.05).The treatment cost of the needle knife group was less than that of the arcuate knife group,and the difference was statistically significant(P<0.05);the hospitalization days of the needle knife group was shorter than that of the arcuate knife group,but the difference was not statistically significant(P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Needle knife fenestration is effective in AOSC patients with difficult intubation during ERCP,which is worthy promoting.

关 键 词：急性梗阻化脓性胆管炎 内镜逆行性胰胆管造影术 针状刀开窗术 弓状刀预切开术 困难插管 十二指肠乳头括约肌预切开术 

分 类 号：R657.45[医药卫生—外科学]