摘要
目的探讨不同原因所致急性化脓性胆管炎（APC）急诊经内镜逆行胰胆管道影（ERCP）的治疗。方法回顾分析2008年1月至2013年5月165例因胆管结石、胆道良性或恶性梗阻所致APC的急诊ERCP术治疗，治疗效果，术后并发症等。结果165例中成功157例，成功率95．2％，有效率100％，住院时间为15-64d，平均24．6d。少部分患者出现急性胰腺炎等并发症，占12．8％，5例有少量出血，占3．2％，所有患者均未发生EST后穿孔。157例患者无死亡病例。经鼻胆管引流的患者，胆汁引流量300～500ml／d，治疗后5～7d症状均缓解。结论随着内镜操作技术的迅速发展和内镜器械的不断更新，APC均可选择内镜下引流，甚至对于结石患者可急诊行内镜下取石。内镜治疗可减轻患者痛苦、缩短住院时间，降低患者治疗成本，提高生活质量，已经逐渐成为治疗胆胰疾病的首选方法。
Objective To investigate the endoscopic management of acute purulent cholangitis. Methods Retrospective analysis of 165 cases emergency ERCP for treating acute purulentcholangitis caused by different reasons was performed. Methods of operation, effects of treatment, and postoperative complications in our department of gastroenterology from January 2008 to May 2013 were retrospectively reviewed. Results There were 157 cases treated by emergency ERCP successfully. The successful and effective rates of endoscopic management were 95.2% and 100%. The hospital stay Varied from 15 to 64 days, averaging 24.6 days.After the procedure, 5 cases （ 3.2% ） had gastrointestinal hemorrhage, 20 cases had pancreatitis （ 12.8% ） and nobody had EST-related perforation.No death in these 157 cases.Of 165 cases 153 were given with ENBD.The Results showed that a mean drainage quantity of bile was 300-500, their symptoms alleviated apparently in 5-7days after the treatment. Conclusions With the rapid development of endoscopic operation techniques and endoscopic instruments constantly updated, we can select the endoscopic drainage for treating acute purulent cholangitis.Sometimes those patients with Bile duct stones can be treated by emergency endoscopic calculus extraction.Endoscopic management can reduce their pain, shorter their hospital stays, reduce their costs of living and improve their quality of lives, it has gradually become the preferred treatment method of biliary and pancreatic diseases.
出处
《浙江临床医学》
2013年第11期1621-1623,共3页
Zhejiang Clinical Medical Journal
