【摘要】：目的:探討巨大膽總管結(jié)石應(yīng)用乳頭括約肌小切開(SEST)加大球囊(15 mm~20mm)擴(kuò)張術(shù)(EPLBD)的安全性及有效性。方法:對(duì)比分析2012年10月~20l4年05月在我們醫(yī)院住院的膽總管結(jié)石直徑在15mm~20mm之間的80例患者行乳頭括約肌小切開加大球囊擴(kuò)張術(shù)(SEST+EPLBD)與傳統(tǒng)的乳頭括約肌大切開加網(wǎng)籃碎石術(shù)的取石療效差異與并發(fā)癥。采用隨機(jī)分組的方法將乳頭括約肌小切開加大球囊擴(kuò)張術(shù)作為觀察組,傳統(tǒng)的乳頭括約肌大切開加網(wǎng)籃碎石術(shù)為對(duì)照組,并比較兩組一期取石成功率、操作時(shí)間、X線照射時(shí)間、術(shù)后胰腺炎、術(shù)后出血穿孔感染等并發(fā)癥情況。結(jié)果:觀察組(43例)及對(duì)照組(37例)一期取石成功率分別為95.34%和94.59%,兩組差異無顯著性;操作時(shí)間分別為26.09±10.56和32.24±9.99,(P0.01),差異有顯著性;X線照射時(shí)間分別為14.79±5.83和19.75±7.12min,P0.05,差異有顯著性;術(shù)后早期并發(fā)癥總發(fā)生率分別為4.6%(2/43)和11%(4/37),實(shí)驗(yàn)過程中無死亡事例報(bào)道。對(duì)照組并發(fā)癥如出血和感染發(fā)生率明顯高于觀察組。結(jié)論:與傳統(tǒng)的方法對(duì)比內(nèi)鏡下十二指腸乳頭括約肌小切開術(shù)加大球囊擴(kuò)張術(shù)(SEST+EPLBD)治療巨大膽總管結(jié)石可縮短操作時(shí)間而且安全、有效。
[Abstract]:Aim: to evaluate the safety and efficacy of small incision of sphincter papillary sphincterotomy (SEST) plus balloon dilation (15 mm~20mm) in the treatment of giant bold common bile duct stones. Methods: 80 cases of choledocholithiasis in our hospital from Oct. 2012 to May 2014 were treated with small incision of papillary sphincter and balloon dilatation with (SEST EPLBD) and traditional sphincterotomy. Methods: from October 2012 to May 2014, 80 cases of choledocholithiasis in our hospital were treated with 15mm~20mm. The difference of curative effect and complication of open-mesh basket lithotripsy. The small incision and balloon dilation of sphincter papillae was used as the observation group, and the traditional large incision of sphincter papillae plus basket lithotripsy was used as the control group. The success rate and operation time of the first stage stone extraction were compared between the two groups. X-ray irradiation time, postoperative pancreatitis, postoperative bleeding and perforation infection and other complications. Results: the success rates of primary stone extraction in observation group (43 cases) and control group (37 cases) were 95.34% and 94.59%, respectively. There was no significant difference between the two groups. The operating time was 26.09 鹵10.56 and 32.24 鹵9.99 (P0.01), and the X-ray irradiation time was 14.79 鹵5.83 and 19.75 鹵7.12 min, P 0.05, respectively. The incidence of early postoperative complications was 4.6% (2 / 43) and 11% (4 / 37) respectively. No death cases were reported during the experiment. The incidence of complications such as bleeding and infection in control group was significantly higher than that in observation group. Conclusion: compared with the traditional method, endoscopic sphincterotomy plus balloon dilation (SEST EPLBD) can shorten the operation time and be safe and effective in the treatment of giant choledocholithiasis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R657.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Xiao-Ming Yang;Bing Hu;;Endoscopic sphincterotomy plus large-balloon dilation vs endoscopic sphincterotomy for choledocholithiasis:A meta-analysis[J];World Journal of Gastroenterology;2013年48期

2 孫娟娟;鞠輝;毛濤;孫學(xué)國;孔心涓;趙清喜;田字彬;;EPLBD不同擴(kuò)張時(shí)間治療膽總管結(jié)石的效果[J];世界華人消化雜志;2014年11期

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本文編號(hào)：2457697