双导丝技术联合经胰管乳头括约肌预切开术在ERCP困难插管患者中的应用效果及对应激反应、插管成功率的影响

Application effect of double guide wire technique combined with transpancreatic papillary sphincterotomy in patients with difficult intubation of ERCP and its influences on stress response and success rate of intubation

目的探讨双导丝技术联合经胰管乳头括约肌预切开术在经内镜逆行胰胆管造影术(ERCP)困难插管患者中的应用效果及对应激反应、插管成功率的影响。方法选取2019年1月至2022年1月的90例ERCP困难插管患者作为研究对象,按照随机数字表法将其分为对照组(n=45)和观察组(n=45)。对照组实施常规经胰管乳头括约肌预切开术,观察组在对照组基础上实施双导丝技术。比较两组的治疗效果。结果插管时(T_(1))、插管后5 min(T_(2)),观察组的皮质醇(Cor)、肾上腺素(E)水平低于对照组(P<0.05)。观察组的插管成功率显著高于对照组,成功插管耗时显著短于对照组(P<0.05)。观察组术后的胰腺炎发生率显著低于对照组(P<0.05)。结论双导丝技术联合经胰管乳头括约肌预切开术应用于ERCP困难插管患者中有助于减轻机体应激反应,提高插管成功率,缩短成功插管耗时,也能降低术后胰腺炎发生率,值得推广。

Objective To investigate the application effect of double guide wire technique combined with transpancreatic papillary sphincterotomy in patients with difficult intubation of endoscopic retrograde cholangiopancreatography(ERCP)and its influences on stress response and success rate of intubation.Methods From January 2019 to January 2022,90 patients with difficult intubation of ERCP were selected as the research objects,and the patients were divided into control group(n=45)and observation group(n=45)according to the random number table method.The control group was given conventional transpancreatic papillary sphincterotomy,and the observation group was given double guide wire technique on the basis of the control group.The therapeutic effects of the two groups were compared.Results At intubation(T_(1))and 5 min after intubation(T_(2)),the levels of cortisol(Cor)and epinephrine(E)in the observation group were lower than those in the control group(P<0.05).The success rate of intubation in the observation group was significantly higher than that in the control group,and the time of successful intubation was significantly shorter than that in the control group(P<0.05).The incidence of postoperative pancreatitis in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The double guide wire technique combined with transpancreatic papillary sphincterotomy applied in patients with difficult intubation of ERCP is helpful to reduce the body stress response,improve the success rate of intubation,shorten the time of successful intubation,and reduce the incidence of postoperative pancreatitis,which is worthy of promotion.