摘要
目的分析逆行胰胆管造影术(ERCP)+内镜下乳头括约肌切开(EST)+内镜下鼻胆管引流(ENBD)治疗胆总管结石的疗效及安全性。方法回顾性分析2019年1月至2022年6月95例胆总管结石患者临床资料,根据治疗方法不同分为两组,46例行ERCP+EST治疗(对照组),49例行ERCP+EST+ENBD治疗(观察组)。应用IBM SPSS Statistics 26.0软件进行统计学分析。围手术期指标、血清淀粉酶、C-反应蛋白(CRP)、白细胞介素-6(IL-6)及肝功能指标等计量资料以(x±s)表示,组间采用独立样本t检验。一次手术成功率、并发症发生率、术后1年复发率等计数资料采用χ^(2)检验。检验水准α=0.05。结果观察组患者住院时间显著低于对照组(P<0.05)。术后24h,观察组患者血清淀粉酶、CRP、IL-6显著低于对照组(P<0.05)。观察组患者并发症总发生率为6.1%,低于对照组的21.7%(P<0.05)。观察组患者术后1年复发率为0.0%,与对照组2.2%比较,差异无统计学意义(P>0.05)。结论ERCP+EST取石联合ENBD引流的一次手术成功率较高,对肝功能影响较小,术后1年复发率、并发症更少,能进一步减轻急性胰腺炎、胆道感染发生风险,缓解炎症反应。
Objective To analyze the efficacy and safety of retrograde cholangiopancreatography(ERCP)+endoscopic papillary sphincterotomy(EST)+endoscopic nasobiliary drainage(ENBD)in the treatment of choledocholithiasis.Methods The clinical data of 95 patients with choledocholithiasis from January 2019 to June 2022 were retrospectively analyzed,and they were divided into two groups according to different treatment methods:46 patients received ERCP+EST treatment(control group)and 49 patients received ERCP+EST+ENBD treatment(observation group).IBM SPSS Statistics 26.0 software was used for statistical analysis.Perioperative indicators,serum amylase,C-reactive protein(CRP),interleukin-6(IL-6)and liver function indicators were expressed as(x±s).Independent sample t test was used between groups.The statistical data of success rate of one operation,complication rate and recurrence rate 1 year after operation were tested byχ2 test.Test levelα=0.05.Results The hospitalization time of observation group was significantly lower than that of control group(P<0.05).24h after operation,serum amylase,CRP and IL-6 in observation group were significantly lower than those in control group(P<0.05).The total complication rate of observation group was 6.1%,which was lower than 21.7%of control group(P<0.05).The recurrence rate of patients in the observation group was 0.0%one year after surgery,which was not statistically significant compared with 2.2%in the control group(P>0.05).Conclusion ERCP+EST combined with ENBD drainage has a higher success rate of one operation,less impact on liver function,less recurrence rate and complications one year after surgery,and can further reduce the risk of acute pancreatitis and biliary tract infection and alleviate inflammation.
作者
刘军
周代琴
徐雪梅
于仕杰
Liu Jun;Zhou Daiqin;Xu Xuemei;Yu Shijie(Department of Gastroenterology,Ganzi Tibetan Autonomous Prefecture People’s Hospital,Kangding Sichuan Province 626000,China;Specialty of Psychoneurological Geriatrics,Ganzi Tibetan Autonomous Prefecture People’s Hospital,Kangding Sichuan Province 626000,China)
出处
《中华普外科手术学杂志（电子版）》
2024年第3期299-302,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
四川省科技计划项目(2020YFS0537)。
关键词
胆总管结石
逆行胰胆管造影术
内镜下乳头括约肌切开
内镜下鼻胆管引流
Choledocholithiasis
Endoscopic Retrograde Cholangiopancreatography
Endoscopic Sphincterotomy
Endoscopic Nasobiliary Drainage
