急诊ERCP治疗老年患者胆总管结石继发急性重症胆管炎的效果

Effect of Emergency ERCP on Acute Severe Cholangitis Secondary to Choledocholithiasis in the Elderly

目的分析急诊经内镜逆行胰胆管造影术(emergency transendoscopic retrograde,ERCP)治疗老年患者胆总管结石继发急性重症胆管炎的有效性及并发症影响。方法选择2020年4月1日—2022年3月4日胆总管结石继发急性重症胆管炎老年患者100例,根据年龄进行分组,以74岁为分界点,60~74岁患者设为对照组,75~91岁患者设为观察组。对所有患者均采用急诊经ERCP治疗,分析两组患者的治疗效果、并发症发生情况等。结果两组患者的有效率比较,差异无统计学意义(P>0.05)。两组患者的住院时间比较,差异无统计学意义(P>0.05);观察组患者并发症发生率略高于对照组,但差异无统计学意义(P>0.05)。观察组患者的白细胞计数(leucocyte count,WBC)、总胆红素(total bilirubin,TBIL)、碱性磷酸酶(alkaline phosphatase,ALP)和对照组比较,差异无统计学意义(P>0.05);血小板计数(platelet count,PLT)、白蛋白(albumin,ALB)数据明显低于对照组(P<0.05)。观察组患者床边无X线ERCP患者多于对照组(P<0.05);但困难插管、十二指肠乳头括约肌切开术(duodenal papillary sphincterotomy,EST)以及二次EST患者与对照组比较,差异无统计学意义(P>0.05)。结论急诊ERCP治疗老年人胆总管结石继发急性重症胆管炎的临床价值较高,其安全可靠,可快速改善老年患者临床症状,保证健康。

Objective To analyze the effectiveness and complications of emergency endoscopic retrograde cholangiopancreatography(emergency transendoscopic retrograde,ERCP)for acute severe cholangitis in elderly patients.Methods A total of 100 elderly patients with acute severe cholangitis from April 1,2020 to March 4,2022 were grouped according to their age,with 74 years old as the cut-off point,patients 60-74 years old as the control group,and patients 75-91 years old as the elderly,and set as the observation group.All patients were treated with emergency ERCP,and the treatment effect and occurrence of complications in the two groups were analyzed.Results There was no significant difference in the effective rate between the two groups(P>0.05).There was no significant difference in hospitalization time(P>0.05);the complication rate was slightly higher than those in the control group,but it was not significant(P>0.05).White blood cell count(leucocyte count,WBC),total bilirubin(total bilirubin,TBIL),ALP(alkaline phosphatase,ALP)(P>0.05);platelet count(platelet count,PLT),albumin(albumin,ALB)were significantly lower than those in the control group(P<0.05).More patients in the observation group without X-ray ERCP than the control group(P<0.05);however,with difficult intubation,EST and secondary EST,no difference was compared with the control group(P>0.05).Conclusion The clinical value of acute severe cholangitis is high,which is safe and reliable,rapidly improves the clinical symptoms of elderly patients and ensures their health.