摘要
目的探讨选择性胆管插管对经内镜逆行性胰胆管造影术(Endoscopic retrograde cholangio-pancreatography,ERCP)后胰腺炎发生率和严重程度的影响。方法随机抽取我院消化内科需要行ERCP手术的患者188例,根据导丝插入方法不同分为治疗组84例和对照组104例,治疗组采用双"十"字交叉标准选择性胆管插管技术,对照组行传统常规插管方法,术后比较两组患者胰腺炎和高淀粉酶血症的发生率、胰腺炎严重程度。结果两组患者胰腺炎发生情况比较,治疗组ERCP术后胰腺炎发生7例,其中轻、中、重度分别为6例、1例和0例,低于对照组的20例(其中轻、中、重度分别为12例、6例和2例),差异有统计学意义(Z=-3.497,P=0.000;χ2=4.487,P=0.034)。两组患者高淀粉酶血症发生情况比较,治疗组高淀粉酶血症发生14例,低于对照组的32例,差异有统计学意义(χ2=5.000,P=0.025)。结论双"十"字交叉标准选择性胆管插管技术能够明显降低ERCP术后胰腺炎和高淀粉酶血症发生率,临床值得推广使用。
Objective To explore effect on incidence and severity of acute pancreatitis by selective bile duct cannulation in ERCP. Methods We selected one hundred and eighty-eight cases from the patients who needed ERCP in Endocrinology department in Chongqing Thirteen People＆#39;s Hospital as research object,which were randomly divided into the treatment group （84 cases） and the control group （104 cases） according to the different guide wire inserted ways. The patients in the treatment group were treated with the“cross standard”selective bile duct intubation techniques, while the patients in the control group were given conventional bile duct intubation techniques. The results of incidence and severity of acute pancreatitis were analyzed. Results The number of pancreatitis occurred in the treatment group （7 cases） was less than that in the control group （20 cases）. The difference was statistically significant （χ^2=4.487, P=0.034）. Among them, the number of patients in light, medium and heavy degree were 6 cases, 1 and 0 respectively in the treatment group, while they were 12 cases, 6 and 2 respectively in the control group. The difference was statistically sig-nificant （Z=-3.497, P=0.000）. On the number of cases in high blood amylase, the treatment group （14 case） was smaller than the control group （32 cases）. The difference was statistically significant （χ^2=5.000,P=0.025）. Conclusion Cross standard selective bile duct cannulation techniques can significantly reduce the incidence of postoperative ERCP pan-creatitis and high blood amylase. It is worth to be recommended in the clinical application.
出处
《海南医学》
CAS
2014年第15期2211-2213,共3页
Hainan Medical Journal
