无痛内镜下逆行胰胆管造影术在限定时间内选择性胆胰管插管的临床应用

Clinical application of selective bile pancreatic duct intubation in painless endoscopic retrograde cholangiopancreatography within limited time

目的探讨无痛内镜下逆行胰胆管造影术(ERCP)在限定时间内行选择性胆胰管插管的临床应用。方法选取2014年2月～2016年1月就诊于湘潭县人民医院行ERCP术患者120例,以随机数表法分为对照组及试验组,每组各60例。其中对照组患者给予常规镇静后行ERCP,试验组患者接受静脉全麻后行ERCP。比较两组在限定时间内的成功插管时间、手术时间、住院时间、术后并发症以及治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果试验组在5、10、20 min限定时间内的实际成功插管时间均显著低于对照组(P <0.05);试验组手术时间、住院时间均短于对照组(P <0.05);试验组并发症发生率低于对照组(P <0.05)。治疗前两组SAS、SDS评分比较差异无统计学意义(P> 0.05),治疗后试验组SAS、SDS评分均低于治疗前(P <0.05),对照组SDS评分较治疗前降低(P <0.05),而SAS评分无明显变化(P> 0.05),且治疗后试验组SAS、SDS评分均低于对照组(P <0.05)。结论无痛ERCP具有缩短插管时间、减少手术操作总时间、降低术后并发症发生率等优势,值得临床推广应用。

Objective To explore the clinical application of selective bile pancreatic duct intubation in painless endoscopic retrograde cholangiopancreatography(ERCP)within limited time.Methods One hundred and twenty patients taking ERCP diagnosis and treatment in Xiangtan County People′s Hospital from February2014to January2016were selected.They were divided into control group and experimental group by random number table method with60cases in each group.The control group was given routine sedation and ERCP,while the experimental group was given intravenous general anesthesia and ERCP.Successful intubation time within limited time,operation time,hospitalization time,postoperative complications and SAS,SDS scores before and after treatment were compared between the two groups.Results Actual successful intubation time within the limited time of5,10,20min in the experiment group were significantly shorter than those in the control group(P<0.05);operation time and hospitalization time of the experiment group were significantly shorter than those of the control group(P<0.05);the complication rate of the experiment group was significantly lower than that of the control group(P<0.05).Before treatment,there was no difference in SAS and SDS scores between the two groups(P>0.05),while after treatment SAS and SDS scores in the experiment group were significantly lower than those before treatment(P<0.05).SDS score in the control group decreased after treatment(P<0.05),but SAS score had no difference before and after treatment(P>0.05).After treatment,SAS and SDS scores in the experimental group were lower than those in the control group(P<0.05).Conclusion The painless ERCP has superiority that can reduce intubation tube time and the total time of operation,reduce the incidence of postoperative complications,and it is worthy of clinical promotion and application.