超声与X线引导下行经内镜逆行性胰胆管造影术治疗胆总管结石的临床对比研究

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摘要目的对比研究超声与X线引导下行经内镜逆行性胰胆管造影术（ERCP）治疗胆总管结石的临床效果。方法选取2019年1月至12月在深圳市龙岗中心医院接受ERCP 治疗的60 例胆总管结石患者作为研究对象，按简单随机化分组方法分为B-ERCP 组与X-ERCP 组，各30 例。B-ERCP 组在超声引导下进行ERCP 治疗，X-ERCP组在X 线引导下进行ERCP 治疗，比较两组的手术成功率及术后恢复情况，记录两组患者的手术指标（手术时间、术中出血量）及术中、术后并发症发生情况，对比两组患者的住院时间及费用。结果 B-ERCP 组的术后恢复情况优于X-ERCP 组，差异有统计学意义（P＜0.05）；B-ERCP 组的术中并发症发生率为13.33%，高于X-ERCP 组的0.00%，差异有统计学意义（P＜0.05）；B-ERCP 组的术后并发症发生率为6.67%，低于X-ERCP 组的30.00%，差异有统计学意义（P＜0.05）；B-ERCP 组的手术时间长于X-ERCP 组，术中出血量多于X-ERCP 组，术后住院时间短于X-ERCP 组，住院费用少于X-ERCP 组，差异有统计学意义（P＜0.05）；两组的手术成功率比较，差异无统计学意义（P＞0.05）。结论超声引导下对胆总管结石患者进行ERCP 术治疗，其手术成功率与X 线引导下无明显差异；与X 线引导比较，超声引导手术时间较长，术中出血量较多，但术后并发症发生率较低，术后住院时间较短，费用较低，且术后恢复情况优于X 线引导。

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	刘宜兵
	戴璟瑜
	兀雅静
	陈夏

关键词 ：超声, X 线, 经内镜逆行性胰胆管造影术, 胆总管结石

Abstract：Objective To compare and study the clinical effect of endoscopic retrograde cholangiopancreatography(ERCP)with ultrasound and X-ray guidance in the treatment of choledocholithiasis.Methods A total of 60 patients with choledocholithiasis undergoing ERCP in the Central Hospital of Longgang District of Shenzhen City from January to December 2019 were enrolled as the research objects.According to simple randomization method,they were divided into the B-ERCP group and the X-ERCP group,30 cases in each group.The B-ERCP group was treated with ERCP under ultrasound guidance,and the X- ERCP group was treated with ERCP under X-ray guidance.The surgical success rate and postoperative recovery were compared between the two groups.The surgical indexes(operation time,intraoperative blood loss),intraoperative and postoperative complications in both groups were recorded.The hospitalization time and cost were compared between the two groups.Results The postoperative recovery of the B-ERCP group was better than that of the X-ERCP group,the difference was statistically significant(P＜0.05).The incidence of intraoperative complications in the B-ERCP group was higher than that in the X-ERCP group(13.33% vs.0.00%),the difference was statistically significant(P＜0.05).The incidence of postoperative complications in the B-ERCP group was lower than that in the X-ERCP group(6.67% vs 30.00%),the difference was statistically significant(P＜0.05).The operation time in the B-ERCP group was longer than that in the X-ERCP group,intraoperative blood loss in the B-ERCP group was more than that in the X-ERCP group,postoperative hospitalization time in the B-ERCP group was shorter than that in the X-ERCP group,and hospitalization cost in the B-ERCP group was less than that in the XERCP group,the differences were statistically significant(P＜0.05).There was no significant difference in the operation success rate between the two groups(P＞0.05).Conclusion There is no significant difference in the surgical success rate between ultrasound and X-ray guided ERCP for choledocholithiasis patients.Compared with X-ray guidance,ultrasound-guided surgery has longer surgery time,more blood loss,but lower incidence of postoperative complications,shorter postoperative hospital stay and lower cost,and the postoperative recovery is better than X-ray guidance.

Key words： Ultrasound X-ray Endoscopic retrograde cholangiopancreatography Choledocholithiasis

基金资助:广东省深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目（LGKCYLWS2018000060）

引用本文:

刘宜兵；戴璟瑜；兀雅静；陈夏. 超声与X线引导下行经内镜逆行性胰胆管造影术治疗胆总管结石的临床对比研究[J]. 中国当代医药, 2021, 28(27): 104-107.
LIU Yi-bing；DAI Jing-yu；WU Ya-jing；CHEN Xia. Clinical comparative study of endoscopic retrograde cholangiopancreatography guided by ultrasound and X-ray in the treatment of choledocholithiasis. 中国当代医药, 2021, 28(27): 104-107.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I27/104

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