高龄患者治疗性ERCP的临床价值及安全性

Clinical value and safety for therapeutic ERCP in elderly patients

目的探讨治疗性内镜逆行胰胆管造影(ERCP)对高龄患者的临床价值及安全性。方法同顾性分析787例行治疗性ERCP患者的临床资料,根据年龄分为高龄组(年龄≥70岁)和非高龄组(年龄<70岁),术后严密观察生命体征变化、有无发热、腹痛症状,化验术后2 h血常规、血淀粉酶,对两组患者治疗成功率及并发症发生率进行分析。结果胆管结石非高龄组患者ERCP治疗成功率为95.1%,高龄组患者ERCP治疗成功率为96.4%,两组之间差异无统计学意义;胰腺、胆道或壶腹恶性肿瘤者非高龄组ERCP成功琦率82.1%,高龄组ERCP成功率79.6%,两组之间差异无统计学意义;非高龄组患者ERCP术后并发症发生率为3.8%,高龄组患者并发症发生率为3.6%,两组间差异无统计学意义。结论治疗性ERCP对高龄患者是一种安全、有效的治疗方法。

Objective To investigate the clinical value and safety of therapeutic endoscopic retrograde cholangiopancreatography(ERCP) in elderly patients.Methods Totally 787 patients with therapeutic ERCP were divided into elderly group(age≥70 years old) and non-elderly group(age<70 years old).Vital signs,fever and abdominal pain were evaluated after ERCP.The levels of serum amylase and blood test were detected in 2 hours after ERCP.The success rates of treatment and incidences of complication in two groups were compared.Results The success rate of treatment in non-elderly group with biliary stones was 95.1%,while the success rate of treatment in elderly group was 96.4%,and no difference was found.The success rate of treatment in non-elderly patients with cancer in pancreas,biliary duct or ampulla was 82.1%,while the success rate of treatment in elderly group was 79.6%,and no difference was found.The difference of the incidences of complication was not significant between the two groups(non-elderly group is 3.8%,elderly group is 3.6%).Conclusion Therapeutic ERCP is safe and effective in elderly patients.