發(fā)布時間：2018-04-04 19:12

  本文選題：膽總管結(jié)石　切入點：內(nèi)鏡下十二指腸乳頭括約肌切開(EST)　出處：《皖南醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討內(nèi)鏡下十二指腸乳頭小切開(SEST)結(jié)合柱狀球囊擴張(EPBD)在治療膽總管結(jié)石中的有效性、安全性。方法:對池州市人民醫(yī)院2012年01月至2016年01月期間行內(nèi)鏡下十二指腸乳頭括約肌切開(EST)方法和內(nèi)鏡下十二指腸乳頭小切開聯(lián)合柱狀球囊擴張(SEST+EPBD)方法治療膽總管結(jié)石共146例的病例數(shù)據(jù)進行回顧性總結(jié)分析,統(tǒng)計、比較兩種方法的取石情況(碎石率、總?cè)∈省⒁淮涡越Y(jié)石取盡率)及并發(fā)癥(出血、消化道穿孔、高胰淀粉酶血癥、急性胰腺炎、膽管炎、結(jié)石復(fù)發(fā)率)的發(fā)生率。結(jié)果:SEST+EPBD組的總?cè)∈蕿?7.01%(65/67)高于EST組96.20%(76/79),差異無統(tǒng)計學(xué)意義(P=10.05);SEST+EPBD組的一次性結(jié)石取盡率為94.02%(63/67)高于EST組91.13%(72/79),差異無統(tǒng)計學(xué)意義(P=0.510.05);SEST+EPBD組的機械碎石率7.46%(5/67)低于EST組15.15%(12/79),差異無統(tǒng)計學(xué)意義(P=0.1470.05),SEST+EPBD組和EST組兩組平均取石時間分別為(30.13±7.04)min和(39.25±7.77)min,(t=7.38,P0.001)差異有顯著統(tǒng)計學(xué)意義。SEST+EPBD組總的并發(fā)癥發(fā)生率為20.90%(14/67)低于EST組39.24%(31/79),差異有統(tǒng)計學(xué)意義(P=0.0170.05);其中在消化道穿孔及高胰淀粉酶血癥、急性胰腺炎、膽管炎的發(fā)生率比較無統(tǒng)計學(xué)意義;SEST+EPBD組出血發(fā)生率為1.49%(1/67)低于EST組10.13%(8/79),差異有統(tǒng)計學(xué)意義(P=0.0310.05);SEST+EPBD組結(jié)石復(fù)發(fā)率為1.49%(1/67)低于EST組10.13%(8/79),差異有統(tǒng)計學(xué)意義(P=0.0310.05)。結(jié)論:內(nèi)鏡下十二指腸乳頭小切開(SEST)聯(lián)合柱狀球囊擴張(EPBD)治療膽總管結(jié)石安全、有效,可以較EST減少操作時間、降低出血及結(jié)石復(fù)發(fā)的風(fēng)險,降低并發(fā)癥的總發(fā)生率。
[Abstract]:Objective: to evaluate the efficacy and safety of endoscopic small incision of duodenal papilla (SEST) combined with columnar balloon dilatation (EPBD) in the treatment of choledocholithiasis.Methods: from January 2012 to January 2016 in Chizhou people's Hospital, endoscopic sphincterotomy of duodenal papilla (EST) and endoscopic small incision of duodenal papilla combined with columnar balloon dilatation (SEST EPBD) were performed in the treatment of common bile duct.The data of 146 cases of calculi were analyzed retrospectively.Statistics were performed to compare the incidence of lithotripsy (lithotripsy rate, total lithotripsy rate, one-time stone removal rate) and complications (hemorrhage, perforation of digestive tract, hyperapancreatemia, acute pancreatitis, cholangitis, stone recurrence rate).緇撴灉:SEST EPBD緇勭殑鎬誨彇鐭崇巼涓，

本文編號：1711302