SEST联合EPBD治疗胆总管结石的临床研究

发布时间：2018-04-04 19:12

  本文选题：胆总管结石　切入点：内镜下十二指肠乳头括约肌切开(EST)　出处：《皖南医学院》2017年硕士论文

【摘要】：目的:探讨内镜下十二指肠乳头小切开(SEST)结合柱状球囊扩张(EPBD)在治疗胆总管结石中的有效性、安全性。方法:对池州市人民医院2012年01月至2016年01月期间行内镜下十二指肠乳头括约肌切开(EST)方法和内镜下十二指肠乳头小切开联合柱状球囊扩张(SEST+EPBD)方法治疗胆总管结石共146例的病例数据进行回顾性总结分析,统计、比较两种方法的取石情况(碎石率、总取石率、一次性结石取尽率)及并发症(出血、消化道穿孔、高胰淀粉酶血症、急性胰腺炎、胆管炎、结石复发率)的发生率。结果:SEST+EPBD组的总取石率为97.01%(65/67)高于EST组96.20%(76/79),差异无统计学意义(P=10.05);SEST+EPBD组的一次性结石取尽率为94.02%(63/67)高于EST组91.13%(72/79),差异无统计学意义(P=0.510.05);SEST+EPBD组的机械碎石率7.46%(5/67)低于EST组15.15%(12/79),差异无统计学意义(P=0.1470.05),SEST+EPBD组和EST组两组平均取石时间分别为(30.13±7.04)min和(39.25±7.77)min,(t=7.38,P0.001)差异有显著统计学意义。SEST+EPBD组总的并发症发生率为20.90%(14/67)低于EST组39.24%(31/79),差异有统计学意义(P=0.0170.05);其中在消化道穿孔及高胰淀粉酶血症、急性胰腺炎、胆管炎的发生率比较无统计学意义;SEST+EPBD组出血发生率为1.49%(1/67)低于EST组10.13%(8/79),差异有统计学意义(P=0.0310.05);SEST+EPBD组结石复发率为1.49%(1/67)低于EST组10.13%(8/79),差异有统计学意义(P=0.0310.05)。结论:内镜下十二指肠乳头小切开(SEST)联合柱状球囊扩张(EPBD)治疗胆总管结石安全、有效,可以较EST减少操作时间、降低出血及结石复发的风险,降低并发症的总发生率。
[Abstract]:Objective: to evaluate the efficacy and safety of endoscopic small incision of duodenal papilla (SEST) combined with columnar balloon dilatation (EPBD) in the treatment of choledocholithiasis.Methods: from January 2012 to January 2016 in Chizhou people's Hospital, endoscopic sphincterotomy of duodenal papilla (EST) and endoscopic small incision of duodenal papilla combined with columnar balloon dilatation (SEST EPBD) were performed in the treatment of common bile duct.The data of 146 cases of calculi were analyzed retrospectively.Statistics were performed to compare the incidence of lithotripsy (lithotripsy rate, total lithotripsy rate, one-time stone removal rate) and complications (hemorrhage, perforation of digestive tract, hyperapancreatemia, acute pancreatitis, cholangitis, stone recurrence rate).缁撴灉:SEST EPBD缁勭殑鎬诲彇鐭崇巼涓，

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