简易胆道测压法对胆囊切除术后综合征患者行EST的指导意义

发布时间：2018-05-08 09:09

本文选题：胆道测压 + 胆囊切除术后综合征　；参考：《中国微创外科杂志》2017年09期

【摘要】：目的探讨简易胆道测压法对胆囊切除术后综合征(post-cholecystectomy syndrome,PCS)行EST的指导意义。方法我院2011年1月~2015年12月对38例PCS经十二指肠镜胆道测压,压力升高者行EST,测量术后第1、2、3天胆管压力并观察症状缓解情况。结果胆道测压35例压力升高,压力为(2.47±0.37)k Pa,最高压力为2.92 k Pa,行EST治疗后胆道压力术后1 d下降为(1.23±0.37)k Pa,术后2 d下降为(1.09±0.32)k Pa,术后3 d下降为(1.15±0.34)k Pa,显著低于术前(P值均=0.000),不适症状消失,右上腹痛症状消失,随访6~24个月,平均13.7月,无症状复发。3例胆管压力未升高者给予心理治疗等辅助治疗后消化道和胆道症状逐渐缓解,腹痛发作频率逐渐下降,治疗后2周症状基本消失,电话随访半年,无症状复发。结论简易胆道测压法操作简便,对PCS病人行EST有重要指导意义,有利于胆道测压技术在更基层的医院开展。
[Abstract]:Objective to explore the guiding significance of simple biliary manometry for post-cholecystectomy syndrome (EST) in post-cholecystectomy. Methods from January 2011 to December 2015, 38 patients with PCS who underwent choledochal pressure measurement via duodenoscope and who had elevated pressure were performed. The bile duct pressure was measured on the 2nd day after operation and the symptom relief was observed. Results the pressure was increased in 35 cases by bile duct manometry. The pressure was 2.47 卤0.37kPaand the maximum pressure was 2.92kPa. the biliary tract pressure decreased to 1.23 卤0.37kPa1 day after EST, 1.09 卤0.32kPa2 days after operation, and 1.15 卤0.34kPa3 days after operation, which was significantly lower than the preoperative P values of 0.000g, the symptoms of discomfort disappeared and the symptoms of right epigastric pain disappeared. Follow up for 6 ~ 24 months (mean 13.7 months) showed that the symptoms of digestive tract and bile duct were gradually relieved and the frequency of abdominal pain was decreased and the symptoms were basically disappeared 2 weeks after treatment. All patients were followed up by telephone for half a year. Conclusion the simple method of bile duct manometry is easy to operate and has important guiding significance for EST in patients with PCS. It is helpful to carry out the technique of biliary manometry in more basic hospitals.
【作者单位】：吉林省前卫医院普外科;长春医学高等专科学校;
【基金】：吉林省卫生厅科研课题(项目编号:7011S032)
【分类号】：R657.4

【相似文献】