高龄患者行治疗性内镜逆行胰胆管造影的安全性和有效性探讨

Safety and efficiency oftherapeutic endoscopic retrograde cholangiopancreatography in elderly patients

[目的]探讨治疗性内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)在高龄患者中应用的有效性和安全性。[方法]将行治疗性ERCP操作的患者169例,按年龄分组,其中≥70岁83例(高龄组),<70岁86例(非高龄组);记录2组患者ASA分级、基础疾病、ERCP操作以及并发症情况,对结果进行统计分析、比较2组患者治疗性ERCP的应用情况,[结果]169例患者进行了181次治疗性ERCP操作。2组间例数、性别比例均差异无统计学意义(P>0.05),高龄组患者ASA分级、胆道系统结石及胰腺或胆道恶性肿瘤发生率均显著高于非高龄组(P<0.05);治疗性ERCP后2组操作成功率、并发症发生率均差异无统计学意义(P>0.05)。[结论]高龄组进行治疗性ERCP操作的疗效与非高龄组一致,治疗性ERCP在高龄患者中的应用是安全、有效的。

[Objective]To compare the efficacy and safety of endoscopic retrograde cholangiopancreatog- raphy （ERCP） in elder patients. [Methods]A total of 169 patients who underwent ERCP between Jan 2010 and Dec 2012 were studied retrospectively. Eighty three patients were 70 years of age or older （Elder group） and 86 patients were 69 years of age or younger （Non-Elder group）. Data about ASA degree,prima- ry diseases, ERCP procedures, complications were recorded and compared between the two groups. [Re- sults]A total of 169 cases were undergone 181 ERCP procedures. Compared with Non-Elder group,Elder group patients in age. sex were similar in both groups. Elder group had a higher ASA degree （P^0.05） than Non-Elder group. The therapeutic ERCP overall successful rate and complications ratee were similar in both groups; Elder group had a higher ASA degree （P〈0.05） than Non-Elder group; compared with non-elder group,Elder group patients have Malignant aetiologies and duodenal peripapilla diverticulum di- agnosis more than Non-Elder group, respectively（P〈0.05）. [Conclusion]Diagnostic and therapeutic ERCP have similar outcomes and complications rate in both elder and non-elder patients. ERCP is effective and safe in elderly patients.