内镜下乳头气囊扩张术治疗胆总管结石的临床观察(1)
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[摘要] 目的 探讨内镜下乳头气囊扩张术(EPBD)治疗胆总管结石的临床效果。 方法 选取2009~2010年我院收治的104例胆总管结石患者作为研究对象，随机分为治疗组和对照组。对照组患者采用传统的外科开腹手术进行治疗；治疗组患者采用内镜下乳头气囊扩张手术，观察两组患者手术的成功率及术后患者并发症情况。 结果 治疗组因有2例患者的结石>2 cm，改用外科开腹手术，对照组患者取石的成功率为100%，治疗组为97.8%。但治疗组患者并发症少于对照组。 结论 内镜下乳头气囊扩张术是一项安全、可靠性较强、禁忌证较少、对胆管括约肌无损伤的治疗胆总管小结石的有效方法，但还需更深一步的研究和观察。
[关键词] 内镜下乳头气囊扩张术；胆总管结石；胆道
[中图分类号] R657.42 [文献标识码] B [文章编号] 1673-9701(2012)04-0149-02
Clinical observation of endoscopic papillary balloon dilatation(EPBD) in treating patients of common bile duct stones
LI Qi LI Zhi LI Jian
Department of General Surgery, Shanghai Yangpu District Central Hospital, Shanghai 200090, China
[Abstract] Objective To investigate the effect of Endoscopic Papillary Balloon Dilation for treatment of choledocholithiasis clinical therapeutic effect. Methods Selected 104 cases choledocholithiasis patients in our hospital from 2009 to 2010 as the study objects, divided them into treatment group and control group, patients in the control group were given conventional surgical laparotomy operation treatment, the treatment group were treated by endoscopic papillary balloon dilation operation for treatment, two groups were observed in patients with operation success rate and patients with complications after operation. Results The treatment group with two patients with stones >2 cm, surgical laparotomy for treatment, the control group patients take stone of the success rate was 100%, 97.8% in the treatment group.But the treatment group of patients with complications were much lower than in the control group patients. Conclusion Endoscopic papillary balloon dilatation is a safe, high reliability, less of the bile duct sphincter without contraindications, treatment of the injury of small common bile duct calculus, but also needs further research and observation.
[Key words] Endoscopic papillary balloon dilatation; Common bile duct stone; Biliary tract
胆总管结石指的是位于胆总管内的结石，是一种常见的胆道疾病，胆总管结石的临床表现主要包括阵发性的上腹疼痛、寒颤、发热等。以前临床上多以外科手术进行胆总管结石的治疗，虽然治疗比较彻底，但手术对患者的创伤较大且恢复慢，引发的并发症也较多[1-2]。内镜下乳头气囊扩张术治疗胆总管结石创伤小、恢复快且并发症较少，有效地避免了外科手术中的不足[3]，现报道如下。
1 资料与方法
1.1 一般资料
选取2009~2010年我院收治的胆总管结石患者104例，其中男39例，女65例，年龄25～84岁，平均61.8岁。全组患者术前影像学(包括B超和磁共振胆胰管成像等)检查结果均显示为胆总管结石，结石最大直径约2.5 cm。全组患者术前检查血清淀粉酶均处于正常范围内，排除合并急、慢性胰腺炎患者。
1.2 方法
104例患者随机分为治疗组和对照组各52例。对照组患者采用常规的外科开腹手术治疗；治疗组患者采用内镜下乳头气囊扩张手术治疗。患者术前禁食8 h以上，术前静脉滴注加贝酯6支 ......
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