球囊扩张与ERCP术后胰腺炎关系的Meta分析

发布时间：2018-05-29 18:23

本文选题：内镜下逆行胰胆管造影术 + 内镜下球囊扩张取石术　；参考：《昆明医科大学》2016年硕士论文

【摘要】：目的探讨内镜下乳头球囊扩张术与患者术后胰腺炎是否有直接关系。方法计算机检索MEDLINE和PUBMED数据库中所有相关文献,检索时限为1995年1月～2015年12月,由2名评价员参考Newcastle-Ottawa NOS病例按照文献质量评价标准,对纳入文献进行独立筛选、提取资料、质量评价,采用RevMan5.0.23分析软件进行Meta分析。结果检索到相关文献共168篇,最终纳入文献共16篇,患者共2130人,其中内镜下乳头球囊扩张取石患者1061例；内镜十二指肠乳头括约肌切开术患者1069例,实施内镜球囊扩张取石术与内镜十二指肠乳头括约肌切开术患者术后胰腺炎发生率的合并优势比为1.88[95%可信区间(1.30-2.71)],P=0.0007,差异有统计学意义。结论通过本次Meta分析表明,预选对象的选择、球囊压迫、反复插管、多次胰管显影及操作者的经验不足是内镜下球囊扩张术后并发胰腺炎的主要危险因素。通过选择合适的患者、优化技术方案,在术前或术后给予药物或预防性的放置胰管支架或鼻胆管,能有效预防内镜下球囊扩张术后胰腺炎的发生。
[Abstract]:Objective to investigate the relationship between endoscopic papillary balloon dilatation and postoperative pancreatitis. Methods all the relevant documents in MEDLINE and PUBMED databases were searched by computer, and the retrieval time was from January 1995 to December 2015. According to the literature quality evaluation criteria, two evaluators were selected independently and the data were extracted. Quality evaluation, RevMan5.0.23 analysis software for Meta analysis. Results A total of 168related articles were retrieved, including 2130 patients, including 1061 patients with endoscopic papillary balloon dilatation, 1069 patients with endoscopic sphincterotomy of duodenal papilla, 1069 patients with endoscopic sphincterotomy, 1061 patients with endoscopic papillary balloon dilatation, 1069 patients with endoscopic sphincterotomy, and 1069 patients with endoscopic papillary sphincterotomy. The incidence of pancreatitis after endoscopic balloon dilatation and endoscopic sphincterotomy was 1.88 [95% confidence interval 1.30-2.71], the difference was statistically significant. Conclusion through the Meta analysis, the selection of pre-selected objects, balloon compression, repeated intubation, multiple pancreatic duct development and lack of experience of the operator are the main risk factors of pancreatitis after endoscopic balloon dilatation. By selecting suitable patients, optimizing the technical scheme, giving drugs before and after operation or placing pancreatic stents or nasobiliary ducts before and after operation, we can effectively prevent the occurrence of pancreatitis after endoscopic balloon dilatation.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R657.5

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