ERCP治疗肝泡型包虫病的有效性分析

发布时间：2018-05-24 11:34

本文选题：肝泡型包虫病 + ERCP　；参考：《青海大学》2017年硕士论文

【摘要】：目的:探讨经内镜下逆行胰胆管造影术(ERCP)在肝泡型包虫病(HAE)的临床应用中的疗效。方法:收集于2012年1月-2016年11月在青海大学附属医院就诊,诊断为肝泡型包虫病并行ERCP治疗的患者资料,将资料分为4组:A组为合并黄疸的HAE患者术前行ERCP减黄组B组为无黄疸的AE患者术前ERCP治疗组C组为HAE患者术后胆道并发症的ERCP治疗组D组为终末期合并黄疸HAE患者的ERCP治疗组。分别记录患者一般情况,测定及比较术前、术后肝功能指标,并观察术后症状改善及早期并发症的发生情况,对终末期患者进行生存质量和生存时间的随访,并行分别统计学分析,得出结果。结果:A组(14例)中13例患者黄疸逐渐消退,1例患者转行经皮肝穿胆道引流术(PTCD)后症状好转,术后与术前肝功能比较差异有统计学意义(P0.05),ERCP术后14天与术前肝功能child-pugh分级、黄疸程度比较差异均有统计学意义(P0.05)。B组患者随机分为ERCP组(10例)和未接受ERCP组(13例),两组患者在拔管时间对比上差异有统计学意义(P0.05);C组中(10例)1例胆道狭窄患者治愈,9例胆漏患者,8例治愈,1例转行手术治疗后治愈,总治愈率90%。D组患者术后3天、7天、1月肝功能较术前比较差异有统计学意义(P0.05),不同时间点的患者生活质量评分的差异有统计学意义。结论:可切除肝泡型包虫合并梗阻性黄疸患者术前ERCP治疗可有效改善肝功能、降低黄疸指数。可切除肝泡型包虫无黄疸患者术前ERCP留置ENBD,可降低手术后胆道并发症发生率。ERCP可作为泡型肝包虫术后胆道并发症(胆漏、胆管狭窄)的治疗选择。ERCP可改善终末期泡肝合并梗阻性黄疸患者生存质量。
[Abstract]:Objective: to evaluate the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of hepatic alveolar hydatid disease (HAE). Methods: data were collected from January 2012 to November 2016 in the affiliated Hospital of Qinghai University for diagnosis of hepatic alveolar hydatidosis treated with ERCP. The data were divided into 4 groups: group A was HAE patients with jaundice before operation, group B was AE patients without jaundice, group B was AE patients without jaundice before operation, group C was HAE patients, group C was postoperative biliary complications of HAE patients, group D was end-stage complicated with jaundice HAE. The patients were treated with ERCP. The general condition of the patients was recorded, the liver function indexes before and after operation were measured and compared, and the improvement of postoperative symptoms and the occurrence of early complications were observed, and the quality of life and survival time were followed up. The results are obtained by parallel statistical analysis. Results among 14 cases in group A, jaundice gradually subsided and 1 patient had improved symptoms after percutaneous transhepatic biliary drainage. There was a significant difference in postoperative liver function between 14 days after operation and 14 days after operation (P 0.05) and child-pugh grade of liver function before operation. The degree of jaundice was significantly different. Group B was randomly divided into ERCP group (n = 10) and ERCP group (n = 13). There was significant difference in extubation time between two groups. 9 cases of bile leakage were cured, 8 cases were cured and 1 case was cured after operation. The total cure rate of patients in group D was 3 days after operation and 7 days after operation. The difference of liver function in 1 month was statistically significant compared with that before operation (P 0.05). The difference of quality of life score of patients at different time points was statistically significant. Conclusion: preoperative ERCP therapy in patients with resectable hepatic alveolar hydatid and obstructive jaundice can effectively improve liver function and decrease jaundice index. ERCP indwelling enBDD before operation in patients with resectable hepatic alveolar hydatid without jaundice can reduce the incidence of postoperative biliary complications. ERCP can improve the quality of life in patients with obstructive jaundice.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R532.32

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