摘要
目的评价导丝引导的选择性胆总管插管对减少 ERCP 术后胰腺炎(PEP)及高淀粉酶血症(HA)的作用。方法采用随机对照法将513例患者按2:1的比例分成导丝超选组(A 组,342例)和传统法造影组(B 组,171例)。于术前及术后第2、24、48 h 监测血淀粉酶,详细记录腹部的症状和体征,根据病情进行必要的治疗。结果 A 组和 B 组在年龄、性别、疾病的种类、ERCP 操作的时间、成功率及操作方法的构成比及术前血淀粉酶水平等均具有可比性(P>0.05)。术后第2、24、48 hA 组的平均血淀粉酶值均显著低于 B 组,P<0.05。A 组中 PEP、HA 的发生率分别为3.5%、35.1%,显著低于 B 组的9.4%、71.3%,P<0.05。结论应用导丝选择性胆总管插管可显著降低 ERCP 术后PEP 及 HA 的发生率。
Objective To evaluate the effect on decrease of post-ERCP panereatitis and hyperamylasemia by seleetive eannulation of eommon bile duet guided by guide wire. Methods Five hundred and thirteen patients were randomly divided into group of seleetive eannulation （ Group A, 342 eases） and group of elassie ERCP（ Group B, 171 eases） aeeording to the ratio 2： 1. Levels of blood amylase for each ease were deteeted before ERCP and at 2 h, 24 h, 48 h of post-ERCP, while symptoms and signs were reeorded earefully. Suitable treatments were given based on individuals. Results Constituent ratio of age, gender, disease classification, period and successful rate of ERCP, methods of operation and level of blood amylase before ERCP between two groups were not significant（ P 〉 0. 05 ）. Average level of blood amylase at 2 h, 24 h, 48 h of post-ERCP in Group A was obviously lower than that in Group B （P 〈 0. 05）. Incidence rate of PEP and HA in Group A was 3.5%, 35.1% respectively, which was significantly lower than that（9.4%, 71.3% ） in Group B, （ P 〈 0. 05）. Conclusion Selective cannulation of common bile duct guided by guide wire can obviously decrease the incidence rate of PEP and HA of post-ERCP.
出处
《中华消化内镜杂志》
2007年第4期250-253,共4页
Chinese Journal of Digestive Endoscopy
关键词
胰胆管造影术
内窥镜逆行
胰腺炎
高淀粉酶血症
选择性插管
Cholangiopancreatography, endoscopic retrograde
Pancreatitis
Hyperamylasemia Selective cannulation
