EPLBD不同扩张时间治疗胆总管结石的效果

发布时间：2018-11-27 11:51

【摘要】：目的:探讨内镜下十二指肠乳头大球囊扩张术(endoscopic papillary large balloon dilation,EPLBD)不同球囊扩张时间治疗胆总管结石的有效性与安全性.方法:2012-08/2013-09采取EPLBD进行经内镜逆行性胰胆管造影术(endoscopic retrogradecholangiopancreatography,ERCP)治疗的胆总管结石患者90例,随机分3组:0 min组、1 min组、5 min组,球囊扩张时间分别为0 min、1min、5 min,比较3组患者取石成功率、机械碎石使用率、操作时间及近期并发症情况.结果:90例患者中有1例因无法忍受扩张疼痛而放弃继续扩张,共有89例患者入选,均顺利完成取石或碎石取石术.结石取净成功率均为100%,机械碎石使用率分别为0 min组14.8%(4/27),1 min组6.3%(2/32),5 min组20%(6/30)(P=0.25).操作时间分别为0 min组:29.5 min±8.62 min,1 min组:24.3 min±6.27min,5 min组:28.6 min±7.58 min(P=0.02).三组患者术中及术后无出血、穿孔、胆道感染及急性胰腺炎等近期并发症,高淀粉酶血症发生率分别为0 min组14.8%(4/27),1 min组0%(0/32),5 min组10%(3/30)(P=0.03).结论:EPLBD不同球囊扩张维持时间治疗胆总管结石均安全有效,1 min的扩张维持时间疗效较好.
[Abstract]:Objective: to evaluate the efficacy and safety of endoscopic balloon dilatation (endoscopic papillary large balloon dilation,EPLBD) in the treatment of choledocholithiasis. Methods: ninety patients with choledocholithiasis treated by endoscopic retrograde cholangiopancreatography (endoscopic retrogradecholangiopancreatography,ERCP) were randomly divided into 3 groups: 0 min group, 1 min group, 5 min group and 0 min, dilation time. The success rate of lithotomy, the utilization rate of mechanical lithotripsy, the operation time and the recent complications were compared between the three groups at 1 min and 5 min,. Results: one out of 90 patients gave up the expansion because they couldn't bear the pain of dilatation. A total of 89 patients were selected and all of them successfully completed lithotomy or lithotripsy. The success rate of stone removal was 100%. The utilization rate of mechanical lithotripsy was 14.8% (4 / 27) in 0 min group, 6.3% (2 / 32) in 1 min group and 20% (6 / 30) in 5 min group (P0. 25). The operation time of 0 min group was 29.5 min 卤8.62 min,1 min group: 24.3 min 卤6.27 min 5 min group: 28.6 min 卤7.58 min (P0. 02). There were no bleeding, perforation, biliary tract infection and acute pancreatitis in the three groups. The incidence of hyperamylase was 14.8% (4 / 27) in 0 min group, 0% (0 / 32) in 1 min group, respectively. 5 10% (3 / 30) in min group (P0. 03). Conclusion: EPLBD is safe and effective in the treatment of choledocholithiasis with different balloon dilatation and maintenance time, and 1 min is effective in the treatment of choledocholithiasis.
【作者单位】：青岛大学医学院;青岛大学医学院附属医院消化内科;
【分类号】：R657.4

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