| EPLBD在老年人胆总管困难结石治疗中的应用 |
| 投稿时间：2017-01-18 修订日期：2017-02-04 点此下载全文 |
| 引用本文：杨俊杰,刘雄昌,杨小强,张其勇,吴琴,杜疆玲.EPLBD在老年人胆总管困难结石治疗中的应用[J].医学研究杂志,2018,47(2):160-163 |
| DOI：
10.11969/j.issn.1673-548X.2018.02.038 |
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| 中文摘要:目的 探讨内镜下乳头大球囊扩张术（EPLBD）在老年胆总管困难结石治疗中的有效性和安全性。方法 106例胆总管困难性结石（横径≥ 13mm或3个以上≥ 10mm）进行EPLBD取石术，按年龄分为A组（<60岁）和B组（≥ 60岁），观察两组合并慢性疾病和解剖畸形、手术成功率、并发症发生率和ERCP次数等指标。结果 B组有较多乳头旁憩室、高血压、高脂血症、心脑血管疾病/痴呆、呼吸系统疾病和心脏病，服用抗凝剂或抗血小板剂也更多（P<0.05）。两组取石成功率分别为88.1%（52/59）和89.4%（42/47），完全取石成功率均为100%，需要机械碎石分别为10.2%（6/59）和12.8%（6/47）。ERCP次数为1.24±0.68和1.17±0.53。并发症的发生率为6.8%（4/59）和2.1%（1/47），在治疗成功率、ERCP次数、并发症的发生率方面两组比较差异无统计学意义（P>0.05）。结论 老年患者EPLBD取石安全、有效。 |
| 中文关键词:老年人 内镜下乳头大球囊扩张术 内镜下括约肌切开术 胆总管大结石 胆石症 |
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| Endoscopic Papillary Balloon Dilation for Difficult Bile Duct Stones Removal in Patients 60 Years Old or Younger |
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| Abstract:Objective To investigate whether endoscopic papillary large balloon dilation (EPLBD) can be safety and effectively performed in patients aged ≥ 60 years.Methods Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13mm in size or with three or more bile duct stones ≥ 10mm. The patients were divided into group A(<60 years)and group B(≥ 60 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatography(ERCP), and incidence of complications were examinedin both groups.Results Group B tended to include significantly more patients with peripapillary diverticulum, hypertension,hyperlipemia,cerebrovascular disease/dementia,respiratory disease/cardiac disease, and patients administered anticoagulant or antiplatelet agent (P<0.05). A, B two groups of lithotomy success rate was 88.1% (52/59) and 89.4% (42/47), and completely removed the success rate is 100%, need mechanical lithotripsy respectively accounted for 10.2% (6/59) and 12.8% (6/47). ERCP was 1.24±0.68 times and 1.17±0.53. The incidence of complications was 6.8% (4/59) and 2.1% (1/47), and the statistical analysis had no significant difference in treatment success rate, ERCP frequency, and incidence of complications.Conclusion EPLBD can be safely performed in elderly patients, the same as in younger patients. |
| keywords:Elderly patients Endoscopic papillary large balloon dilation Endoscopic sphincterotomy Large bile duct stones Choledocholithiasis |
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