急性化脓性胆管炎急诊ERCP取石的安全性分析

发布时间：2018-03-22 16:21

本文选题：急性化脓性胆管炎　切入点：ERCP　出处：《南昌大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解胆总管结石并急性化脓性胆管炎患者行急诊ERCP治疗中急诊取石并引流与先引流再择期取石两种治疗方法的安全性及有效性。方法:回顾性分析南昌大学第一附属医院消化内镜中心自2012年03月至2016年06月期间因胆总管结石所致急性化脓性胆管炎(Acute cholangitis)并行急诊ERCP术(Endoscopic retrograde cholangiopancreatography)治疗的患者。观察急诊取石及引流组(A:观察组)与先引流再择期取石组(B:对照组)两组之间患者的一般情况、临床特征、ERCP成功率、术后并发症、住院时间及住院费用等情况的差异。结果:在此期间共有1038例急性化脓性胆管炎患者行急诊ERCP术,根据纳入标准及排除标准筛选出241例患者进行研究。A组133例(男:64,女69),B组108例(男:52,女56)。两组患者的基线资料相似,241例患者均成功完成急诊ERCP术。与B组比较,A组患者住院天数更短、住院费用更少,两者有统计学差异;但是两组术后并发症发生率无统计学差异(18.0%vs18.5%,P0.05);两组患者手术前后肝功能指标均有明显好转。结论:急诊ERCP可以有效的解除AOSC患者的胆道梗阻症状,急诊取石并引流可以缩短住院天数、减少住院费用,而不增加术后并发症的风险。
[Abstract]:Objective: to investigate the safety and efficacy of emergency lithotomy and drainage, drainage and selective lithotomy in patients with choledocholithiasis complicated with acute suppurative cholangitis. From March 2012 to June 2016, patients with acute suppurative cholangitis caused by choledocholithiasis in the first affiliated Hospital were treated with emergency ERCP. The general situation of the patients between the two groups: the first drainage group and the selective stone extraction group B: control group. Results: 1038 patients with acute suppurative cholangitis underwent emergency ERCP operation. According to the inclusive criteria and exclusion criteria, 241 patients were selected for study. Group A: 133 (male: 64, female: 69), group B: 108 (male: 52, female: 56). The baseline data of both groups were similar and 241 patients successfully completed emergency ERCP operation. The days of hospitalization of the patients in the group were shorter. The cost of hospitalization is less, there is a statistical difference between the two; However, there was no significant difference in the incidence of postoperative complications between the two groups (P 0.05). The liver function indexes of the two groups were significantly improved before and after operation. Conclusion: emergency ERCP can effectively relieve the symptoms of biliary obstruction in patients with AOSC. Emergency lithotomy and drainage can shorten the length of stay and reduce the cost of hospitalization without increasing the risk of postoperative complications.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.42

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