基层医院ERCP对阻塞性黄疸疾病诊治的安全性和有效性.docVIP

基层医院ERCP对阻塞性黄疸疾病诊治的安全性和有效性 何雪云 324004 浙江省衢州市 浙江衢化医院消化科作者简介：何雪云，男，1969—，副主任医师，地址：浙江省衢州市衢化文昌路62号，邮编324004，手机邮箱：hxy690929@yahoo.cn 324004 浙江省衢州市 浙江衢化医院消化科 作者简介：何雪云，男，1969—，副主任医师，地址：浙江省衢州市衢化文昌路62号，邮编324004，手机邮箱：hxy690929@yahoo.cn 510120 广东省广州市 广州医学院第一附属医院 510282 广东省广州市 南方医科大学珠江医院 【摘要】 目的：通过实际病例分析评估内镜下逆行胰胆管造影（endoscopic retrograde cholangiopancreatography，ERCP）在基层医院对阻塞性黄疸疾病诊治的安全性和有效性。方法：应用OlypmusJF240型电子十二指肠镜，Olympus260电子胃镜，ERBE高频电刀等，对243例年龄在32～89岁的阻塞性黄疸患者进行ERCP诊断和治疗。结果：243例阻塞性黄疸中，经ERCP证实胆总管结石223例（占91.8%）、胆管肿瘤8例（3.3%）、胆管良性狭窄6例（2.5%）、壶腹周围癌3例（1.2%）、胆总管囊肿、Mirizzi综合征和医源性损伤各1例（均＜0.5%）。实际操作和治疗过程中并发症少，其中胰腺炎6例（2.5%），高淀粉酶血症13例（5.3%），出血4例（1.6%），经适当处理后均恢复，未发生穿孔和心脑血管意外等严重并发症。结论：基层医院使用ERCP对阻塞性黄疸疾病的诊断成功率高，治疗安全可靠，并发症的发生率低。 【关键词】 基层医院；ERCP；安全性；有效性 The safety and efficacy of endoscopic retrograde cholangiopancreatography of obstructive jaundice disease in the district hospital (He Xueyun，324004 Quzhou，Zhejiang province，Quhua hospital of Zhejiang province；Lai Rongde，510120 Guangzhou，Guangdong province，The first affiliated hospital of Guangzhou Medical College；Li Qilin，510282 Guangzhou，Guangdong province，Zhujiang Hospital of the Southern Medical University) Abstract Objective：To evaluate the safety and effectiveness of endoscopic retrograde cholangiopancreatography（ERCP）to obstructive jaundice disease in the district hospital. Methods：There were 243 cases with obstructive jaundice disease，range from 32 to 89 years old，accepted the diagnosis and treatment of ERCP，during which，the Olypmus JF240 electronic duodenoscopes，Olympus 260 electronic gastroscope，ERBO High frequency electrotome，and others，were used. Results：Among the 243 cases of obstructive jaundice disease，we identified，223 was common bile duct calculi，eight was bile duct neoplasms，six was benign stricture of bile ducts，three was periampullary carcinoma，and one choledochal cyst，one Mirizzi syndrome and one iatrogenic injury. There were few complications during the procedure and therapy of ERCP，a