本文選題：內(nèi)鏡逆行胰膽管造影術(shù)1 + 膽總管結(jié)石2��； 參考：《山西醫(yī)科大學》2017年碩士論文

【摘要】：目的:評估內(nèi)鏡下大球囊擴張術(shù)(EPLBD)治療膽總管結(jié)石(CBDs)的安全性和有效性。方法:回顧性分析山西醫(yī)科大學第一醫(yī)院消化科于2013年6月至2016年5月行內(nèi)鏡逆行胰膽管造影(ERCP)相關技術(shù)治療CBDs的患者,按納入排除標準,最終內(nèi)鏡下括約肌切開術(shù)(EST)聯(lián)合EPLBD組入選48例,EPLBD組35例。分別對兩組患者的臨床資料,結(jié)石清除率,機械碎石使用率及并發(fā)癥進行比較。結(jié)果:一次性完整結(jié)石清除率EST聯(lián)合EPLBD組和EPLBD組分別是46例(95.8%)、33例(94.3%),機械碎石術(shù)使用率分別是7例(14.7%)、7例(17.1%),差異均無統(tǒng)計學意義。兩組使用擴張球囊的中位數(shù)均是15mm,P=0.548。操作時間(從插管成功到結(jié)石清除)分別為35.92±7.67min、32.66±6.02min,EPLBD組時間較短,差異有統(tǒng)計學意義(P=0.040)。兩組胰腺炎、高淀粉酶血癥發(fā)生率相似,差異無統(tǒng)計學意義。結(jié)論:1.單純EPLBD和EST聯(lián)合EPLBD是一樣有效的、安全的治療CBDs的方式。2.EPLBD前EST可能是不必要的,單純EPLBD可以簡化治療膽總管結(jié)石的程序,降低設備成本。
[Abstract]:Objective: to evaluate the safety and efficacy of endoscopic balloon dilatation (EPLBDD) in the treatment of choledocholithiasis.Methods: the patients with CBDs treated by endoscopic retrograde cholangiopancreatography (ERCP) from June 2013 to May 2016 in Department of Digestive, first Hospital of Shanxi Medical University were retrospectively analyzed.The final endoscopic sphincterotomy combined with EPLBD group included 48 cases of EPLBD group (35 cases).The clinical data, stone clearance rate, utilization rate of mechanical lithotripsy and complications were compared between the two groups.Results: the one-time complete stone clearance rate in EST combined with EPLBD group and EPLBD group were 46 cases (95. 8%) and 33 cases (94. 3%), respectively. The utilization rate of mechanical lithotripsy was 7 cases (14. 7%) and 7 cases (17. 1%) respectively. The difference was not statistically significant.The median value of dilated balloon use in both groups was 15 mm.The operation time (from successful intubation to stone removal) was 35.92 鹵7.67min (32.66 鹵6.02min), respectively, and the time of EPLBD was shorter than that of EPLBD (P < 0.040).The incidence of hyperamylase was similar in the two groups with no statistical significance.Conclusion 1.Simple EPLBD and EST combined with EPLBD are equally effective. 2. EPLBD pre- may be unnecessary. Simple EPLBD can simplify the procedure of treating choledocholithiasis and reduce the cost of equipment.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R657.42

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