经内镜逆行胰胆管造影术治疗高龄胆总管结石的临床疗效及对血清糖类抗原19-9水平的影响

发布时间：2018-04-19 00:29

本文选题：内镜 + ERCP　；参考：《中国老年学杂志》2016年10期

【摘要】：目的探讨经内镜逆行胰胆管造影术(ERCP)治疗高龄胆总管结石的临床疗效及对血清糖类抗原(CA)19-9水平的影响。方法选取2013年1月至2015年1月来该院消化内科及肝胆外科就诊的高龄胆总管结石患者172例,根据随机数字计数法分成观察组(ERCP术)和对照组(常规肝胆外科手术)各86例。比较两组相关临床指标、炎症指标、CA19-9水平以及取石成功率及并发症发生情况。结果观察组手术时间、腹痛的缓解时间、黄疸消退时间、抗感染治疗的时间以及住院时间均显著少于对照组(均P0.05);两组患者术后肿瘤坏死因子(TNF)-α、白介素(IL)-1及IL-6水平均显著上升,CA19-9水平显著下降,且观察组以上指标变化更明显(均P0.05);两组患者取石成功率无统计学意义(P0.05);观察组患者并发症发生率显著低于对照组(P0.05)。结论 ERCP治疗高龄胆总管结石患者的临床疗效显著,术后恢复快、并发症更少,安全性高,且可有效降低血清CA19-9的水平,值得推广。
[Abstract]:Objective to investigate the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of choledocholithiasis in elderly patients and its effect on serum carbohydrate antigen CA19-9 level.Methods 172 elderly patients with choledocholithiasis from January 2013 to January 2015 were randomly divided into two groups: the observation group (ERCP) and the control group (routine hepatobiliary surgery).The clinical indexes, inflammation index and CA19-9 level, the success rate of lithotomy and the occurrence of complications were compared between the two groups.Results in the observation group, the operation time, the relief time of abdominal pain and the time of jaundice regression were observed.The time of anti-infective therapy and the length of hospitalization were significantly shorter than those of the control group (all P 0.05), the levels of TNF- 伪, IL-1and IL-6 increased significantly and the levels of CA19-9 decreased significantly in both groups.The changes of the above indexes in the observation group were more obvious (all P 0.05); the success rate of lithotomy in the two groups was not statistically significant; the incidence of complications in the observation group was significantly lower than that in the control group (P 0.05).Conclusion the clinical effect of ERCP in treating elderly patients with choledocholithiasis is remarkable, the postoperative recovery is fast, the complications are less, the safety is high, and the level of serum CA19-9 can be reduced effectively, which is worth popularizing.
【作者单位】：皖南医学院第一附属医院消化内科;皖南医学院第一附属医院胃肠外科;皖南医学院第一附属医院肝胆外科;
【基金】：安徽省卫生厅医学科研课题(No.09A085)
【分类号】：R575.62

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