摘要
目的探讨内镜下十二指肠乳头括约肌小切开联合球囊扩张术对胆总管结石的疗效。方法将2013年6月~2015年1月梅州市人民医院确诊胆总管结石120例患者随机分为EST组（单纯内镜下乳头括约肌切开组）和SEST＋EPBD组（内镜下乳头括约肌小切开联合球囊扩张组）,各60例。比较两组出血、穿孔、高淀粉酶血症、急性胰腺炎等近期并发症,和胆道逆行感染、结石复发等远期疗效。并比较两组取石成功率、手术时间、住院时间。结果 SEST＋EPBD组出血发生率低于EST组,差异有统计学意义（P〈0.05）;高淀粉酶血症及急性胰腺炎发生率两组差异无统计学意义（P〉0.05）;两组均未出现穿孔。SEST＋EPBD组一次性取石成功率和总取石成功率高于EST组,差异有统计学意义（P〈0.05）。SEST＋EPBD组平均手术时间和平均住院时间均短于EST组,差异有统计学意义（P〈0.05）;术后定期复查,1年后统计SEST＋EPBD组结石复发少于EST组,差异均有统计学意义（P〈0.05）。结论 SEST联合EPBD在提高取石成功率的基础上,手术操作时间和住院时间均有效缩短,术后并发症少,安全有效,值得临床推广。
Objective To explore the effect of endoscopic sphincterotomy combined with balloon dilatation in treatment of choledocholithiasis. Methods 120 patients who were diagnosed as choledocholithiasis in Meizhou People＇s Hospital from June 2013 to January 2015 were randomly allocated to the endoscopic sphincterotomy group（EST group） and the endoscopic sphincterotomy combined with balloon dilatation group（SEST＋EPBD group）, with 60 in each. Short-term complications including hemorrhage, perforation, hyperamylasemia, acute pancreatitis and so on and long-term curative effects including biliary retrograde infection, recurrent stone and so on of two groups were compared. In addition, success rate of stone removal of two groups were compared. Results Incidence of hemorrhage of the SEST＋EPBD group was significantly lower than that of the EST group. The difference was statistically significant（P〈0.05）. Differences in incidences of hyperamylasemia and acute pancreatitis of two groups had no statistical significance（P〈0.05）. No perforation occurred in two groups. The success rate of one-time stone removal and the total success rate of stone removal of the SEST＋EPBD group were both higher than those of the SEST＋EPBD group. The difference was statistically significant（P〈0.05）. The average operation time and the average hospitalization stay of the SEST＋EPBD group were both shorter than those of the EST group. The difference was statistically significant（P〈0.05）. In regular reexaminations of 1 year after operation, recurrence of stone of the SEST＋EPBD group was fewer than that of the EST group. The difference was statistically significant（P〈0.05）. Conclusion SEST combined with EPBD can shorten operation time and hospitalization stay at the basis of improving the success rate of stone removal. It has fewer postoperative complications and it is safe and effective, worthy of clinical promotion.
出处
《中国医药科学》
2016年第5期205-207,218,共4页
China Medicine And Pharmacy
