PST在ERCP治疗中的疗效及安全性分析

Therapeutic effect and safety of precut sphincterotomy in ERCP

目的:探讨经内镜乳头括约肌预切开术在ERCP治疗中的疗效及安全性。方法:回顾性分析我院2006年6月至2007年6月230例行ERCP取石治疗患者,其中对24例常规方法不能胆道深部插管者行乳头预切开术(PST)并取石治疗,观察术后患者的临床症状评分、血淀粉酶、大便隐血试验和住院时间等指标并进行比较。结果:EST组成功率89.57%,高淀粉酶血症发生率19.77%,住院时间中位数7 d;PST组成功率100%,高淀粉酶血症发生率26.32%,住院时间中位数6 d。两组病例在临床症状评分、高淀粉酶血症发生率、大便隐血试验阳性率和住院时间等方面均无明显差异。结论:乳头预切开术是ERCP诊疗困难时成功进入胆道的一项重要技术手段,正确的预切开术和常规ERCP同样有效、安全。

Objective：To evaluate therapeutic effect and reliability of endoscopic precut sphincterotomy （PST） with endoscopic retrograde cholangilapancreatography（ERCP）. Methods：The data of 230 patients received ERCP between June of 2006 and 2007 were analyzed retrospectively, among whom 206 patients underwent endoscopic sphincterotomy （EST） and 24 were treated with precut sphincterotomy, with evaluation of symptom scoring, determination of hemodiastase, fecal occult blood testing and hospital stay. Results ： 89.57% patients in EST group were treated compared with 100% in PST group. The incidence of hyperamylasemia was 19.77% in EST group to 26.32% in another, and the median length of hospital stay was 7 days in EST group to 6 days in PST group. The results suggested no significant difference with regard to symptom scoring, incidence of hyperamylasemia, positive fecal occult blood and length of stay. Conclusion ： PST is an effective and applicable method for treatment concerning ERCP as well as EST.