摘要
目的探讨内镜下乳头括约肌小切开联合气囊扩张术对比乳头括约肌大切开治疗胆总管结石的效果。方法2007—2010年滕州市中心人民医院消化科确诊为胆总管结石患者246例,随机分为观察组124例和对照组122例。两组患者经内镜逆行胰胆管造影(endoscopic retrograde cholangio-pancreatography,ERCP)取石术中分别采用十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)、乳头括约肌球囊扩张术(endoscopic papillary balloon dilation,EPBD)方法。比较两组结石取出成功率、近期并发症发生率、平均住院日。所有患者术后随访1年,评估远期并发症。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果结石取出成功率:观察组96.8%,对照组95.1%,比较差异无统计学意义(χ2=0.45,P>0.05)。近期并发症发生率观察组9.7%,对照组18.9%,比较差异有统计学意义(χ2=4.24,P<0.05)。远期并发症发生率观察组4.03%,对照组15.6%,比较差异有统计学意义(χ2=9.30,P<0.05)。平均住院日:观察组(8.0±2.9)d、对照组(9.0±3.2)d,两组比较差异有统计学意义(t=2.57,P<0.05)。结论内镜下乳头括约肌小切开联合气囊扩张术优于乳头括约肌大切开,是治疗胆管结石安全、有效、简便的方法。
Objective To evaluate the therapeutic efficacy of minor endoscopic sphincterotomy （EST） combined with endo- scopic papillary balloon dilation（EPBD） versus major endoscopic sphinctemtomy for common bile duct stones. Methods A total of 246 cases who had been diagnosed as having common bile duct stones in the department of gastroenterology of Tai irn central hospital in 2007 - 2010 were randomly divided into two groups ： EST ＋ EPBD group（ n = 124） and FAST group （ n = 122）. The former received EST plus EPBD, while the latter EST during endoscopic retrograde （ERCP）. Both groups were compared for the success rate of stone removal, incidence of short - term complications and av- erage hospital stay. All patients were followed up for one year and evaluated for long - term complications. Measurement data were processed with t - test, count data with ）（2 test, the result of P 〈 0.05 was considered to be statistically signifi- cant. Results The success rate of stone removal was 96.8 % in EST ＋ EPBD group and 95.1% in EST group, and there was no significant difference（x2 = 0.45 ,P 〉 0.05 ）. The incidence of short - term complications was 9.7% and 18.9% re- spectively in EST ＋ EPBD group and EST group, which showed significant difference（x2 = 4.24 ,P 〈 O. 05）. The incidence of long - term complications was 4.03% and 15.6% respectively in EST ＋ EPBD group and EST group, which showed sig- nificant difference（X2=9. 30,P 〈 0.05）. There was significant difference in average hospital stay between EST ＋ EPBD group and EST group （9.0 ± 3.2 vs 8.0 ± 2.9, t = 2. 57, P 〈 0.05 ）. Condusions Minor endoscopic sphinctcretomy combined with endoscopic papillary balloon dilation is superior to major endoscopic sphincterotomy, which is a safe, effec- tive and convenient method for common bile duct stones.
出处
《社区医学杂志》
2013年第20期34-36,共3页
Journal Of Community Medicine
