本文選題：膽道測壓 + 膽囊切除術(shù)后綜合征��； 參考：《中國微創(chuàng)外科雜志》2017年09期

【摘要】：目的探討簡易膽道測壓法對膽囊切除術(shù)后綜合征(post-cholecystectomy syndrome,PCS)行EST的指導(dǎo)意義。方法我院2011年1月~2015年12月對38例PCS經(jīng)十二指腸鏡膽道測壓,壓力升高者行EST,測量術(shù)后第1、2、3天膽管壓力并觀察癥狀緩解情況。結(jié)果膽道測壓35例壓力升高,壓力為(2.47±0.37)k Pa,最高壓力為2.92 k Pa,行EST治療后膽道壓力術(shù)后1 d下降為(1.23±0.37)k Pa,術(shù)后2 d下降為(1.09±0.32)k Pa,術(shù)后3 d下降為(1.15±0.34)k Pa,顯著低于術(shù)前(P值均=0.000),不適癥狀消失,右上腹痛癥狀消失,隨訪6~24個月,平均13.7月,無癥狀復(fù)發(fā)。3例膽管壓力未升高者給予心理治療等輔助治療后消化道和膽道癥狀逐漸緩解,腹痛發(fā)作頻率逐漸下降,治療后2周癥狀基本消失,電話隨訪半年,無癥狀復(fù)發(fā)。結(jié)論簡易膽道測壓法操作簡便,對PCS病人行EST有重要指導(dǎo)意義,有利于膽道測壓技術(shù)在更基層的醫(yī)院開展。
[Abstract]:Objective to explore the guiding significance of simple biliary manometry for post-cholecystectomy syndrome (EST) in post-cholecystectomy. Methods from January 2011 to December 2015, 38 patients with PCS who underwent choledochal pressure measurement via duodenoscope and who had elevated pressure were performed. The bile duct pressure was measured on the 2nd day after operation and the symptom relief was observed. Results the pressure was increased in 35 cases by bile duct manometry. The pressure was 2.47 鹵0.37kPaand the maximum pressure was 2.92kPa. the biliary tract pressure decreased to 1.23 鹵0.37kPa1 day after EST, 1.09 鹵0.32kPa2 days after operation, and 1.15 鹵0.34kPa3 days after operation, which was significantly lower than the preoperative P values of 0.000g, the symptoms of discomfort disappeared and the symptoms of right epigastric pain disappeared. Follow up for 6 ~ 24 months (mean 13.7 months) showed that the symptoms of digestive tract and bile duct were gradually relieved and the frequency of abdominal pain was decreased and the symptoms were basically disappeared 2 weeks after treatment. All patients were followed up by telephone for half a year. Conclusion the simple method of bile duct manometry is easy to operate and has important guiding significance for EST in patients with PCS. It is helpful to carry out the technique of biliary manometry in more basic hospitals.
【作者單位】： 吉林省前衛(wèi)醫(yī)院普外科;長春醫(yī)學(xué)高等�？茖W(xué)校;
【基金】：吉林省衛(wèi)生廳科研課題(項目編號:7011S032)
【分類號】：R657.4

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