摘要
目的:探讨十二指肠乳头切开术(endoscopic sphincterotomy,EST)联合内镜下乳头气囊扩张术(endoscopic papillary balloon dilation,EPBD)用于胆总管结石取石的疗效及安全性。方法:选择2011年2月—2013年2月收治的164例接受内镜取石治疗的胆总管结石患者,其中82例患者采用EST联合EPBD取石(EST+EPBD组),其余82例患者采用EST取石(EST组),比较2组患者取石时间、碎石率、一次性结石取净率及并发症(出血、消化道穿孔、急性胰腺炎、高淀粉酶血症、胆管炎)发生率。结果:EST+EPBD组取石时间为(39.4±11.2)min,低于EST组[(45.2±20.5)min],差异有统计学意义(P<0.05);EST+EPBD组一次性结石取净率为95.1%(78/82),高于EST组[90.2%(74/82)],差异无统计学意义(P>0.05);EST+EPBD组碎石率为9.8%(8/82),低于EST组[21.9%(18/82)],差异有统计学意义(P<0.05);EST+EPBD组总的并发症发生率为21.9%(18/82),高于EST组[20.7%(17/82)],差异无统计学意义(P>0.05)。结论:EST联合EPBD用于胆总管结石取石安全、有效,可较EST缩短取石时间、降低碎石率。
Objective：To evaluate the efficiency and safety of endoscopic sphincterotomy（EST） plus endoscopic papillary balloon dilation（EPBD） for removal of common bile duct（CBD） stones.Methods：A total of 164 patients with CBD stones were enrolled.Among them,82 cases received EST plus EPBD（EST ＋ EPBD group） while the other 82 cases only received EST（EST group）.The procedure time,the rate of using mechanical lithotripsy,the rate of complete stone removal after the first session,the complication（hemorrhage,intestinal perforation,acute pancreatitis,hyperamylasemia,cholangitis） rate were compared between the two groups.Results：Total procedure time in EST＋ EPBD group was （39.4 ± 11.2）min,significantly shorter than that in EST group[（45.2 ± 20.5）min],P＜0.05.The rate of complete stone removal after the first session in EPBD ＋ EST group was 95.1％ （78/82）,higher than that in EST group[90.2％ （74/82）],P＞0.05.The rate of using mechanical lithotripsy was 9.8 ％ （8/82） in EST ＋ EPBD group,significantly lower than that in EST group[21.9 ％ （18/82）],P＜0.05.The complication rate was 21.9％（18/82） in EPBD＋ EST group and 20.7％（17/82） in EST group,P＞0.05.Conclusions：EPBD plus EST is safe and effective for removal of CBD stones,with shorter procedure time and lower rate of using mechanical lithotripsy compared with EST.
出处
《中国临床医学》
2013年第6期785-787,共3页
Chinese Journal of Clinical Medicine
