摘要
目的评估90岁及以上高龄患者行治疗性ERCP的安全性和有效性。方法回顾性分析2001年至2009年间长海医院内镜中心行ERCP的37例共42例次90岁及以上高龄患者（观察组）的临床资料，并按与观察组操作例次比例1：4设计同期65岁及以下符合匹配条件的患者（对照组，152例共168例次），比较两组ERCP操作的完成情况、并发症发生率及其严重程度。结果观察组ERCP操作完全成功率、部分成功率和失败率分别为73．81％（31／42）、19．05％（8／42）和2．38％（1／42），对照组对应分别为85．12％（143／168）、12．50％（21／168）和2．38％（4／168），两组比较差异均无统计学意义（P均〉0．05）；对照组无终止操作病例，观察组有2例次（4．76％）因合并症终止操作，观察组终止操作发生率明显高于对照组（P=0．039）。观察组并发症总的发生率为7．14％（3／42），略高于对照组的6．55％（11／168）（P〉0．05），胰腺炎、出血、感染发生率及并发症各级程度比较组间差异均无统计学意义（P均〉0．05），且两组均无穿孔、死亡病例。结论治疗性ERCP对于90岁及以上高龄患者是安全和有效的，但应关注合并症并及早发现可能由合并症引起的不良事件。
Objective To evaluate the safety and efficacy of therapeutic ERCP for patients above 90 years of age. Methods The data of 37 patients of above 90 years who underwent 42 ERCP procedures from January 2001 to December 2009 were studied retrospectively and compared with those of 152 matched patients （ 168 procedures） below 65 years old at a 1：4 ratio for success rate and complications. Results The rate of complete success, partial success, and failure in observation group was 73.81% （31/42 ） , 19.05% （8/42） and 2. 38% （1/42） , respectively, which were similar （P 〉0. 05） with those in control group, with complete success rate at 85.12% （143/168） , partial success rate at 12. 50% （21/168） and failure rate at 2. 38% （4/168）. The rate of terminated operation in observation group （4.76%, 2/42） was significantly higher than that of the control group （0. 00% , O, P =0. 039）. The overall rate of complication in observation group was 7. 14% （3/42）, slightly higher than that of the control group （6.55%, 11/168, P 〉 0. 05）. There was no significant difference between the two groups regarding the rates and severity of such complications as pancreatitis, hemorrhage and infection （ P 〉 0. 05 ）. No perforation or death was observed.Conclusion Therapeutic ERCP for patients of 90 years or older is safe and effective. Adverse events related to chronic concomitant diseases need early detection and proper management.
出处
《中华消化内镜杂志》
2012年第10期558-562,共5页
Chinese Journal of Digestive Endoscopy
关键词
老年人
90以上
胰胆管造影术
内窥镜逆行
安全性
治疗结果
Aged, 90 and over
Cholangiopancreatography, endoscopic retrograde
Safety
Treatment outcome
