摘要
目的加强对内镜逆行胰胆管造影(ERCP)相关肠穿孔危险因素的认识,提高ERCP诊疗技术的安全性。方法收集该院以及在国内医学刊物公开发表的ERCP相关肠穿孔的临床数据,回顾性分析ERCP相关肠穿孔的危险因素。结果累计收集具有完整资料的ERCP诊疗术患者31 184例次,累计68例次发生肠穿孔,发生率为0.22%。穿孔发生部位分布:球部、降部、输入攀、输出攀、乳头周围及不明部位;穿孔发生的原因有:乳头切开32例,胆管内导丝置入14例,拉直镜身13例,插入7例,毕II式术后4例,脊柱畸形2例,支架2例及不明原因1例。结论 ERCP相关肠穿孔的主要危险因素是:治疗性ERCP、十二指肠镜操作不当、非常规操作、脊柱畸形等;术前充分评估患者的危险因素,提高术者的操作技术,尤其是相关的治疗技术,细致、规范操作是防止ERCP相关十二指肠穿孔的重要措施。
[Objectives] To put emphasis on the associated risk factors in order to improve the operating technique and to make sure clinical safety while performing diagnosis and treatment with ERCP. [Methods] A retrospective analysis on the risk factors for ERCP-related intestinal perforation was based on clinical data from our hospital as well as domestic medical publications. [ Results ] Accumulative intact record has shown that 68 cases of intestinal perforation-took place among 31, 184 cases in-patients who accepted ERCP treatment, with an incidence rate of 0.22%. The distribution of perforation included bulb, descending, input, output, nipple and other unknown area. The risk factors of perforation were associated with EST in 32 cases, the guide wire insertion duct in 14 cases, lens body straightening in 13 cases, inserts in 7 cases, type II after completion in 4 cases, spinal deformity in 2 cases, stands in 2 cases, 1 case with unknown causes as well. [Conclusions] The major risk factors for ERCP- related intestinal perforation are therapeutic ERCP, improper operations, unconventional operations and spinal deformity. With regard to reduce the incidences of ERCP-related duodenal perforation, it is very important to evaluate such preoperative risk factors as far as possible, in particular to follow up meticulous and standard operating guideline.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第2期169-172,共4页
China Journal of Endoscopy
关键词
内镜逆行胰胆管造影
并发症
肠穿孔
endoscopic retrograde cholangiopancreatography
complications
intestinal perforation
