發(fā)布時間：2018-03-14 06:13

  本文選題：經(jīng)內(nèi)鏡逆行胰膽管造影　切入點：膽道支架　出處：《石河子大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的:通過回顧性的分析歷年我院惡性膽管梗阻確診病例經(jīng)內(nèi)鏡下放置膽管支架后的化驗指標、臨床癥狀改善情況,術(shù)后并發(fā)癥發(fā)生率,支架通暢時間及生存期,探討內(nèi)鏡下逆行胰膽管造影(endoscopic retrograde cholangio pancreatography,ERCP)放置不同膽道支架治療膽道惡性梗阻的療效,為今后尋找惡性膽管梗阻的最佳治療方案提供依據(jù)。方法:回顧性分析2007年1月至2013年6月期間在蘭州軍區(qū)烏魯木齊總醫(yī)院消化科確診膽道惡性梗阻行內(nèi)鏡下支架置入的患者,按不同治療方法分為三組,即單塑料支架組,雙塑料支架組和金屬支架組,觀察各組的成功率、引流效果、早期并發(fā)癥發(fā)生情況、支架通暢時間及生存時間,并對各個觀察指標進行統(tǒng)計學分析對比差異是否存在統(tǒng)計學意義。結(jié)果:1.單塑料支架、金屬支架組成功率顯著高于雙塑料支架組(P值均0.05),金屬支架組與單塑料支架組差異無統(tǒng)計學意義(P0.05)。2.三組術(shù)后3天的肝功能指標顯著好轉(zhuǎn),分別與術(shù)前相比差異均有統(tǒng)計學意義(P值均0.05)。3.單塑料支架組的早期并發(fā)癥發(fā)生率高于雙塑料支架組、金屬支架組(P值均0.05),金屬支架和雙塑料支架組間無顯著差異(P0.05)。4.雙塑料支架組的通暢時間明顯長于單塑料支架組,金屬支架組的支架通暢時間明顯長于雙塑料支架組(P值均0.05)。三組之間及兩兩之間平均生存時間均無統(tǒng)計學差異(P0.05)。結(jié)論:內(nèi)鏡下留置膽管支架能有效緩解膽道梗阻的臨床癥狀;金屬支架組通暢時間明顯長于雙塑料支架組,雙塑料支架組通暢時間明顯長于單塑料支架組,且金屬支架組的并發(fā)癥發(fā)生率低于單、雙塑料支架組;對于預(yù)計生存期較長的患者盡量選擇金屬支架。
[Abstract]:Objective: to analyze retrospectively the laboratory indexes, clinical symptoms, postoperative complications, duration of stent patency and survival of malignant bile duct obstruction diagnosed by endoscopy in our hospital. To evaluate the effect of endoscopic retrograde cholangio pancreatography ERCP on the treatment of malignant biliary obstruction by endoscopic retrograde cholangiopancreatography (ERCP). Methods: from January 2007 to June 2013, the patients with malignant biliary obstruction diagnosed by endoscopic stenting in Department of Digestive, Urumqi General Hospital of Lanzhou military region were analyzed retrospectively. According to different treatment methods, the patients were divided into three groups: single plastic stent group, double plastic stent group and metal stent group. The success rate, drainage effect, occurrence of early complications, patency time and survival time of stent were observed in each group. The differences were statistically analyzed and compared with each other. Results: 1. Single plastic scaffold, The success rate of metal stent group was significantly higher than that of double plastic stent group (P < 0.05). There was no significant difference between metal stent group and single plastic stent group. The incidence of early complications in the single plastic stent group was higher than that in the double plastic stent group. There was no significant difference between the metal stent group and the double plastic stent group. The patency time of the double plastic stent group was significantly longer than that of the single plastic stent group, and there was no significant difference between the metal stent group and the double plastic stent group. The time of stent patency in metal stent group was significantly longer than that in double plastic stent group (P < 0.05). There was no significant difference in mean survival time between the three groups and between two groups. Conclusion: endoscopic biliary stents can effectively relieve the clinical symptoms of biliary obstruction. The patency time of metal stent group was longer than that of double plastic stent group, the patency time of double plastic stent group was longer than that of single plastic stent group, and the incidence of complications in metal stent group was lower than that in single plastic stent group. Use metal stents as far as possible for patients with longer life expectancy.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R730.5

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