本文關(guān)鍵詞： 內(nèi)鏡逆行胰膽管造影術(shù) 胰腺疾病 膽道疾病 兒童　出處：《廣西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：評(píng)價(jià)經(jīng)內(nèi)鏡逆行胰膽管造影術(shù)(ERCP)在小于10歲兒童膽胰疾病的診治價(jià)值。 方法：回顧分析2003年至2011年我院10例年齡小于10歲的膽胰疾病患兒的臨床資料，總結(jié)兒童ERCP的診治價(jià)值，并對(duì)成功率、并發(fā)癥和預(yù)后進(jìn)行相關(guān)分析。 結(jié)果：10例患兒，男性3例，女性7例，年齡2～10歲，平均5.2歲。10例患兒共進(jìn)行了10次ERCP操作，成功率90%(9/10),均在全身麻醉下進(jìn)行，其中診斷性ERCP3例，治療性ERCP6例，其中單純膽道疾病3例，單純胰腺疾病2例，合并膽胰疾病4例。其中膽總管結(jié)石3例，膽管狹窄2例，膽總管囊腫1例。急性胰腺炎5例，慢性胰腺炎1例。治療手段包括鼻膽管引流，乳頭括約肌切開(kāi)，取石術(shù)，球囊擴(kuò)張。術(shù)后并發(fā)癥發(fā)生率30%(3/10),3例患兒出現(xiàn)血淀粉酶升高，其中輕癥急性胰腺炎1例，高淀粉酶血癥2例。術(shù)前10例患兒皆存在腹痛，伴有黃疸2例，隨訪6～60月，ERCP術(shù)后腹痛總體緩解率70%(7/10),黃疸緩解率100%（2/2）。 結(jié)論：1.診斷和治療性ERCP在兒童膽胰疾病的診療中有較高的安全性和有效性。 2.兒童ERCP術(shù)后胰腺炎并不少見(jiàn)，，術(shù)前應(yīng)做好充分的風(fēng)險(xiǎn)和療效評(píng)估,術(shù)后嚴(yán)密觀察，及時(shí)處理并發(fā)癥，預(yù)后良好。
[Abstract]:Objective: to evaluate the value of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment of biliary and pancreatic diseases in children under 10 years old. Methods: the clinical data of 10 children with cholangiopancreatic disease aged less than 10 years from 2003 to 2011 in our hospital were analyzed retrospectively. The value of diagnosis and treatment of ERCP in children was summarized and the success rate was evaluated. Complications and prognosis were analyzed. Results 10 cases of ERCP were performed in 10 cases, male 3 cases, female 7 cases, age 2 to 10 years old, mean 5.2 years old. 10 cases underwent 10 ERCP procedures, the success rate was 90 / 10). All patients were performed under general anesthesia, including diagnosed ERCP3 and therapeutic ERCP6, including 3 cases of simple biliary tract disease and 2 cases of simple pancreatic disease. Choledocholithiasis in 3 cases, bile duct stricture in 2 cases, choledochal cyst in 1 case, acute pancreatitis in 5 cases and chronic pancreatitis in 1 case. The incidence of postoperative complications was 30% 10 / 10 cases with elevated serum amylase in 3 cases, including 1 case with mild acute pancreatitis. There were 2 cases of hyperamylase, 10 cases had abdominal pain and 2 cases had jaundice before operation. The overall remission rate of abdominal pain was 70% 10% after ERCP for 6 ~ 60 months follow up. The relief rate of jaundice is 100 / 2 / 2. Conclusion\\\ ERCP is safe and effective in diagnosis and treatment of biliary and pancreatic diseases in children. 2. Pancreatitis after ERCP is not uncommon in children. It is necessary to evaluate the risk and curative effect before operation, observe closely after operation, deal with complications in time, and have a good prognosis.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 施新崗,李兆申,許國(guó)銘,鄒曉平,金震東,孫振興;兒童胰腺炎ERCP術(shù)后并發(fā)癥研究[J];胰腺病學(xué);2002年03期

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