内镜下大球囊扩张术治疗胆总管结石的临床分析

发布时间：2018-04-16 03:39

本文选题：内镜逆行胰胆管造影术1 + 胆总管结石2　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:评估内镜下大球囊扩张术(EPLBD)治疗胆总管结石(CBDs)的安全性和有效性。方法:回顾性分析山西医科大学第一医院消化科于2013年6月至2016年5月行内镜逆行胰胆管造影(ERCP)相关技术治疗CBDs的患者,按纳入排除标准,最终内镜下括约肌切开术(EST)联合EPLBD组入选48例,EPLBD组35例。分别对两组患者的临床资料,结石清除率,机械碎石使用率及并发症进行比较。结果:一次性完整结石清除率EST联合EPLBD组和EPLBD组分别是46例(95.8%)、33例(94.3%),机械碎石术使用率分别是7例(14.7%)、7例(17.1%),差异均无统计学意义。两组使用扩张球囊的中位数均是15mm,P=0.548。操作时间(从插管成功到结石清除)分别为35.92±7.67min、32.66±6.02min,EPLBD组时间较短,差异有统计学意义(P=0.040)。两组胰腺炎、高淀粉酶血症发生率相似,差异无统计学意义。结论:1.单纯EPLBD和EST联合EPLBD是一样有效的、安全的治疗CBDs的方式。2.EPLBD前EST可能是不必要的,单纯EPLBD可以简化治疗胆总管结石的程序,降低设备成本。
[Abstract]:Objective: to evaluate the safety and efficacy of endoscopic balloon dilatation (EPLBDD) in the treatment of choledocholithiasis.Methods: the patients with CBDs treated by endoscopic retrograde cholangiopancreatography (ERCP) from June 2013 to May 2016 in Department of Digestive, first Hospital of Shanxi Medical University were retrospectively analyzed.The final endoscopic sphincterotomy combined with EPLBD group included 48 cases of EPLBD group (35 cases).The clinical data, stone clearance rate, utilization rate of mechanical lithotripsy and complications were compared between the two groups.Results: the one-time complete stone clearance rate in EST combined with EPLBD group and EPLBD group were 46 cases (95. 8%) and 33 cases (94. 3%), respectively. The utilization rate of mechanical lithotripsy was 7 cases (14. 7%) and 7 cases (17. 1%) respectively. The difference was not statistically significant.The median value of dilated balloon use in both groups was 15 mm.The operation time (from successful intubation to stone removal) was 35.92 卤7.67min (32.66 卤6.02min), respectively, and the time of EPLBD was shorter than that of EPLBD (P < 0.040).The incidence of hyperamylase was similar in the two groups with no statistical significance.Conclusion 1.Simple EPLBD and EST combined with EPLBD are equally effective. 2. EPLBD pre- may be unnecessary. Simple EPLBD can simplify the procedure of treating choledocholithiasis and reduce the cost of equipment.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.42

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