高龄胰胆疾病患者临床特点及内镜逆行胰胆管造影术的诊治效果分析

Analysis of clinical characteristics of elderly patients with pancreaticobiliary diseases and the diagnostic effect of endoscopic retrograde cholangiopancreatography

目的探究高龄胰胆疾病患者的临床特点及内镜逆行胰胆管造影术的诊治效果。方法 200例高龄胰胆疾病患者作为研究对象,根据年龄不同分为观察组(≥80岁,高龄组, 113例)和对照组(<80岁,低龄组, 87例)。两组患者均接受内镜逆行胰胆管造影术治疗。观察分析所有患者的临床特点及诊治效果;比较观察组和对照组的并发症发生情况。结果术后能下床活动的患者196例(98.0%),长期卧床的患者4例(2.0%)。术后出现腹痛的患者64例(32.0%),腹痛且伴有黄疸的患者24例(12.0%),无腹痛感但有黄疸的患者40例(20.0%),身体发热且肝功能异常的患者44例(22.0%),无明显症状的患者28例(14.0%)。治疗后,治疗成功率为98.0%(196/200)。手术过程中诊断出胆管结石92例(46.0%),恶性胆道梗阻86例(43.0%),良性胆管狭窄14例(7.0%),胰管结石8例(4.0%)。观察组出血发生率13.3%高于对照组的4.6%,差异有统计学意义(P<0.05);两组高淀粉酶血症及胆道感染发生率比较差异无统计学意义(P>0.05)。结论为高龄胰胆疾病患者采用内镜逆行胰胆管造影术治疗具有较高的成功率和安全指数。

Objective To investigate the clinical characteristics of elderly patients with pancreaticobiliary diseases and the diagnostic effect of endoscopic retrograde cholangiopancreatography. Methods A total of 200 elderly patients with pancreaticobiliary diseases as study subjects were divided into observation group(≥80 years of age, senior group, 113 cases) and control group(<80 years of age, young group, 87 cases) by age. Both groups received endoscopic retrograde cholangiopancreatography for treatment. The occurrence of complications was compared between the two groups. Results 196 patients(98.0%) were able to do off-bed activity after operation, and 4 patients(2.0%) were long-term bedridden. After operation, 64 patients(32.0%) had abdominal pain, 24 patients(12.0%) had abdominal pain and jaundice, 40 patients(20.0%) had jaundice without abdominal pain, 44 patients(22.0%) had fever and abnormal liver function, 28 patients(14.0%) had no obvious symptoms. After treatment, the success rate of treatment was 98.0%(196/200). During the operation, 92 cases(46.0%) of cholelithiasis, 86 cases(43.0%) of malignant biliary obstruction, 14 cases(7.0%) of benign biliary strictures and 8 cases(4.0%) of pancreatic duct stone were diagnosed. The incidence of bleeding 13.3% in the observation group was significantly higher than 4.6% in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in incidence of hyperamylasemia and biliary tract infection between the two groups(P>0.05). Conclusion Endoscopic retrograde cholangiopancreatography provides a high success rate and safety index in the elderly patients with pancreaticobiliary diseases.