本文選題：膽總管結(jié)石　切入點：乳頭肌切開術　出處：《皖南醫(yī)學院》2017年碩士論文

【摘要】：目的:探討內(nèi)鏡下乳頭括約肌小切開聯(lián)合氣囊擴張術對膽總管結(jié)石的治療效果。方法:回顧性分析2014.02至2016.11在池州市人民醫(yī)院內(nèi)鏡中心行ERCP取石者71例,其中內(nèi)鏡下乳頭肌小切開聯(lián)合氣囊擴張膽總管取石患者26例,內(nèi)鏡下乳頭括約肌切開取石患者45例,兩組資料具有可比性,對比分析兩組療效:?一次性結(jié)石清除率,?術后近期并發(fā)癥。結(jié)果:1.一次性取石成功率:內(nèi)鏡下乳頭肌小切開聯(lián)合氣囊擴張組為96.2%,單純?nèi)轭^肌切開組為97.8%,兩組對比差異無統(tǒng)計學意義(p0.05)。2.近期并發(fā)癥:(1)出血:內(nèi)鏡下乳頭肌小切開聯(lián)合氣囊擴張組3.8%,單純?nèi)轭^肌切開組發(fā)生率為0,兩組比較(P0.05)無統(tǒng)計學意義;(2)穿孔:兩組均無穿孔病例;(3)術后胰腺炎:內(nèi)鏡下乳頭肌小切開聯(lián)合氣囊擴張組為3.8%,單純?nèi)轭^肌切開組為8.8%,兩組對比無顯著差異(P0.05)。3.所取結(jié)石直徑(cm):內(nèi)鏡下乳頭肌小切開聯(lián)合氣囊擴張組為1.41±0.69,單純?nèi)轭^肌切開組為0.70±0.35,兩組對比有顯著差異(P0.05)。結(jié)論:內(nèi)鏡下乳頭括約肌小切開聯(lián)合氣囊擴張組與乳頭括約肌切開組早期并發(fā)癥及一次性取石成功率基本相當,但內(nèi)鏡下乳頭括約肌小切開聯(lián)合氣囊擴張術取石直徑明顯大于乳頭括約肌切開組。故內(nèi)鏡下乳頭肌小切開聯(lián)合氣囊擴張術對于治療較大膽總管結(jié)石者取石更為安全。
[Abstract]:Objective: to investigate the effect of endoscopic sphincterotomy combined with balloon dilatation in the treatment of choledocholithiasis. Methods: 71 cases of choledocholithiasis treated with ERCP from 2014.02 to 2016.11 in the endoscopic center of Chizhou people's Hospital were analyzed retrospectively. Endoscopic papillary muscle incision combined with balloon dilatation choledocholithiasis in 26 patients, endoscopic sphincterotomy in 45 patients with lithotomy, the two groups of comparable data, the two groups of comparative analysis of the efficacy of two groups? One-time stone removal rate? Results 1. The success rate of one-off lithotomy: 96. 2 in endoscopic papillary myotomy combined with balloon dilatation group and 97. 8 in simple papillary myotomy group. There was no significant difference between the two groups (P < 0. 05, P < 0. 05, P < 0. 01). Endoscopic papillary myotomy combined with balloon dilatation group 3.8%, simple papillary muscle incision group 0, the two groups compared with P0.05) no statistically significant perforation: both groups without perforation cases / 3) postoperative pancreatitis: endoscopic papillary myotomy combined with small incision. There was no significant difference between the two groups in the diameter of calculi: 1.41 鹵0.69 in endoscopic papillary muscle incision combined with balloon dilatation group, 0.70 鹵0.35 in simple papillary myotomy group, and there was significant difference between the two groups. Conclusion: the early complications of endoscopic sphincterotomy combined with balloon dilatation group are similar to those of sphincterotomy group, and the success rate of one-off lithotomy is similar to that of endoscopic sphincterotomy group. But endoscopic sphincterotomy combined with balloon dilatation was significantly larger than that in the papillary sphincterotomy group, so endoscopic papillary sphincterotomy combined with balloon dilatation was more safe for the treatment of larger choledocholithiasis.
【學位授予單位】：皖南醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R657.42

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本文編號：1656991