摘要
目的探讨经内镜逆行胰胆管造影术(ERCP)中置入胰管支架对困难胆管插管患者ERCP术后急性胰腺炎(PEP)的预防效果。方法120例行ERCP诊疗发生困难胆管插管的患者采用随机数字表法随机分成2组,一组术中置入胰管支架(观察组),另一组未置入(对照组),对比分析2组ERCP术后高淀粉酶血症、PEP的发生率以及术后患者腹痛评分结果。结果观察组发生ERCP术后高淀粉酶血症15例(27.3%),PEP5例(8.3%),无一例重症PEP,术后患者腹痛评分(3.82±1.48)分;对照组发生ERCP术后高淀粉酶血症18例(30.0%),PEP14例(23.3%),重症PEP2例(3.3%),术后患者腹痛评分(4.78±1.93)分。2组ERCP术后高淀粉酶血症发生率比较,差异无统计学意义(P〉0.05);观察组PEP、重症PEP发生率以及术后患者腹痛评分均明显低于对照组,差异均有统计学意义(P〈0.05)。结论置入胰管支架可以有效降低胆管插管困难所引起的PEP的风险,并能有效缓解患者术后疼痛,具有较好的临床应用价值。
Objective To investigate the efficacy of pancreatic duct stent in preventing post-ERCP pancreatitis (PEP) of difficult bile duct cannulation. Methods A total of 120 patients who underwent diffi- cult bile duct cannulation during routine ERCP were randomized to receive pancreatic duct stent placement ( S group ) or not ( NS group), and the incidence of PEP, hyperamylasemia and scores of abdominal pain were analyzed. Results There were 15 cases of hyperamylasemia and 5 cases of PEP occurred in S group, but no severe PEP was observed. The score of abdominal pain was (3.82 ± 1.48) in S group. There were 18 cases of hyperamylasemia and 14 cases of PEP occurred, including 2 severe PEP in NS group. The score of abdominal pain was (7.48 ± 1.93 ) in NS group. There was no significant difference in the incidence of hy- peramylasemia between the two groups (P 〉 0. 05). The incidence of PEP, severe PEP and the scores of ab- dominal pain were lower in the S group (P 〈 0.05 ). Conclusion Placement of pancreatic duct stent can re- duce the PEP rate of difficult bile duct cannulation and relieve the abdominal pain.
出处
《中华消化内镜杂志》
2014年第7期403-406,共4页
Chinese Journal of Digestive Endoscopy
基金
南京市卫生局青年科技人才启动项目(QYK09166)