1000例经内镜逆行胰胆管造影中严重并发症的临床分析.pdfVIP

昆明医学院学报 2010， (9): 52- 54 CN 53 -1049/ R JournaI of Kunming MedicaI University 1 000 例经内镜逆行膜胆管造影中严重并发症的临床分析 卿德科，罗 丁，毛静熙，余少明，李胜宏 (成都军区昆明总医院肝胆外科，成都军区肝胆外科中心，云南昆明 650032) [摘要]目的探讨经内镜逆行膜胆管造影 (ERCP) 术后严重并发症的发生及防治经验教训11. 方法 回顾 性分析 1999 年 1 月至2∞8 年 12 月 10 年戚都军区昆明总医院肝胆外科 Iαm 例次 ERCP 临床资料中严重并发 症的发生及防治方法，并总结其经验教训11. 结果 共发生严重并发症 II 例，且主要出现在 ERCP 开展早期， 其中死亡5 例，治愈6 例.死亡病例以急性重症胆管炎为主，急性重症膜腺炎、上消化道大出血、十二指肠破 裂次之;治愈病例中 1 例遗留永久膜管狭窄、慢性复发性膜腺炎.结论 ERCP 术中就应积极预防并发症，一 旦发生则应及早确定其救治为案，犹豫观望、延迟处理对急性重症胆管炎、大出血、肠破裂等常是致命的. [关键词]经内镜逆行膜胆管造影;并发症:急性膜腺炎;急性胆管炎;出血 [中图分类号] R445.4 (文献标识码] A (文章编号] 1 ∞3 - 4706 (2010) 09 - 0052 - 03 Report of Severe Complications in 1 000 Cases of ERCP QING De - ke , LUO Ding , MAO Jing - xi , YU Shao - ming , Li Sheng - hong (Dept. 0/Hepωobiliary Surge厅， Kunming General Hospital 0/PLA , Hepatobili町Surgery Centre 0/ Chengdu Command , Kunming Yunnan 650032 , China) [AbstractJ Objective To summarize experiences and lessons in preventing and managing complications associated wi出 ERCP. Method TotaIly 1 000 c描础。f ERCP were colIected during January 1999-December 2008 for summarizing the experiences and lessons in preventing and managing complications a.!sociated with ERCP. Results Severe complications took place in 11 c幽es among them in the early stage of ERCP. Of the 11 C幽础， 5 c困es were dead , and 6 c副es were cured. The causes of the death c甜es were mainly acute severe cholangitis , secondly acute severe pancreatitis , massive hemorrhage of the upper alimentary tract , and duodenal rupture. Chronic pancreatitis and straitness of the pancreatic duct were found in 1 of 6 cured ca.!es. Conclusions Measures for preventing complications should be taken from ERCP operation