经内镜逆行胰胆管造影在小于10岁儿童应用的临床价值

发布时间：2018-01-26 17:57

本文关键词： 内镜逆行胰胆管造影术胰腺疾病胆道疾病儿童　出处：《广西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：评价经内镜逆行胰胆管造影术(ERCP)在小于10岁儿童胆胰疾病的诊治价值。方法：回顾分析2003年至2011年我院10例年龄小于10岁的胆胰疾病患儿的临床资料，总结儿童ERCP的诊治价值，并对成功率、并发症和预后进行相关分析。结果：10例患儿，男性3例，女性7例，年龄2～10岁，平均5.2岁。10例患儿共进行了10次ERCP操作，成功率90%(9/10),均在全身麻醉下进行，其中诊断性ERCP3例，治疗性ERCP6例，其中单纯胆道疾病3例，单纯胰腺疾病2例，合并胆胰疾病4例。其中胆总管结石3例，胆管狭窄2例，胆总管囊肿1例。急性胰腺炎5例，慢性胰腺炎1例。治疗手段包括鼻胆管引流，乳头括约肌切开，取石术，球囊扩张。术后并发症发生率30%(3/10),3例患儿出现血淀粉酶升高，其中轻症急性胰腺炎1例，高淀粉酶血症2例。术前10例患儿皆存在腹痛，伴有黄疸2例，随访6～60月，ERCP术后腹痛总体缓解率70%(7/10),黄疸缓解率100%（2/2）。结论：1.诊断和治疗性ERCP在儿童胆胰疾病的诊疗中有较高的安全性和有效性。 2.儿童ERCP术后胰腺炎并不少见，，术前应做好充分的风险和疗效评估,术后严密观察，及时处理并发症，预后良好。
[Abstract]:Objective: to evaluate the value of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment of biliary and pancreatic diseases in children under 10 years old. Methods: the clinical data of 10 children with cholangiopancreatic disease aged less than 10 years from 2003 to 2011 in our hospital were analyzed retrospectively. The value of diagnosis and treatment of ERCP in children was summarized and the success rate was evaluated. Complications and prognosis were analyzed. Results 10 cases of ERCP were performed in 10 cases, male 3 cases, female 7 cases, age 2 to 10 years old, mean 5.2 years old. 10 cases underwent 10 ERCP procedures, the success rate was 90 / 10). All patients were performed under general anesthesia, including diagnosed ERCP3 and therapeutic ERCP6, including 3 cases of simple biliary tract disease and 2 cases of simple pancreatic disease. Choledocholithiasis in 3 cases, bile duct stricture in 2 cases, choledochal cyst in 1 case, acute pancreatitis in 5 cases and chronic pancreatitis in 1 case. The incidence of postoperative complications was 30% 10 / 10 cases with elevated serum amylase in 3 cases, including 1 case with mild acute pancreatitis. There were 2 cases of hyperamylase, 10 cases had abdominal pain and 2 cases had jaundice before operation. The overall remission rate of abdominal pain was 70% 10% after ERCP for 6 ~ 60 months follow up. The relief rate of jaundice is 100 / 2 / 2. Conclusion\\\ ERCP is safe and effective in diagnosis and treatment of biliary and pancreatic diseases in children. 2. Pancreatitis after ERCP is not uncommon in children. It is necessary to evaluate the risk and curative effect before operation, observe closely after operation, deal with complications in time, and have a good prognosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.7

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