两种胆管冲洗法预防胆管结石复发的比较分析
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v6i6.10998
Abstract
目的：比较胆总管结石患者行内镜下逆行胰胆管造影(ERCP)术后,放置鼻胆管外引流冲洗(对照组)与取石后用100ml生理盐水冲洗胆道且不放置鼻胆管(实验组)这两种方法在结石复发情况、住院费用以及并发症发生情况方面的差异。方法：徐州矿务集团总医院消化内科在2019年1月至2020年12月期间,纳入234例胆总管结石患者为研究对象。有128例被归入对照组,106例被归入实验组,对这些患者的临床资料进行回顾性分析,比较两组患者临床资料结果无统计学差异,随访观察患者的结石首次复发情况。结果：实验组及对照组复发率及并发症发生率相当,实验组较对照组住院费用低。结论：取石术后100ml生理盐水冲洗胆道与放置鼻胆管引流冲洗预防结石复发的效果相似,可减少患者住院费用。
Keywords
胆管结石复发；治疗策略；生理盐水胆管冲洗；鼻胆管冲洗
Full Text
PDF - Viewed/Downloaded: 0 TimesReferences
[1] 李积强,张桂信.胆总管取石术后结石复发危险因素的研究进展[J].临床肝胆病杂志,2023,39(01):231-237.
[2] 林延延.盐水冲洗预防ERCP术后胆总管结石复发的临床研究及胆道微环境在复发性胆总管结石成石过程中的作用探索[D].兰州大学,2023.
[3] KimDI,KimMH,Lee SK,et al.Risk factors for recurrence of primary bile duct stones after endoscopic biliary sphinct erotomy[J].Gastrointest Endosc,2001,54(1):42-48.
[4] Kim KY,Han J,Kim HG,et al.Late complications and stone recurrence rates after bile duct stone removal by endoscopic sphincterotomy and large balloon dilation are similar to those after endoscopic sphincterotomy alone[J].Clin Endosc,2013, 46(6):637-642.
[5] Lujian P,Xianneng C,Lei Z.Risk factors of stone recurre nce after endoscopic retrograde cholangiopancreatography for common bile duct stones[J].BMC Med,2020,99(27):e20412.
[6] Wu Y,Zhang Y,Jiang XM,et al.Risk factors for single and multiple recurrences for endoscopic retrograde cholangiopan creatography and open choledochotomy in treating choledoc holithiasis[J].Gastroenterol Res Pract,2023,2023:4738985.
[7] Deng F,Zhou M,Liu PP,et al.Causes associated with recur rent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography: A large sample sized retrospective study[J].World J Clin Cases,2019,7(9):1028-1037.
[8] Park BK, Seo JH, Jeon HH, Choi JW, Won SY, Cho YS, Lee CK, Park H, Kim DW. A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea. J Gastroenterol.2018;53:670–678.
[9] Deng F, Zhou M, Liu PP, Hong JB, Li GH, Zhou XJ, Chen YX. Causes associated with recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancre atography: A large sample sized retrospective study. World J Clin Cases.2019May6;7(9):1028-1037.
[10] Wang X, Wang X, Sun H, Ren G, Wang B, Liang S, Zhang L, Kang X, Tao Q, Guo X, Luo H, Pan Y. Endoscopic Papillary Large Balloon Dilation Reduces Further Recurrence in Patients With Recurrent Common Bile Duct Stones: A Randomized Controlled Trial.Am J Gastroenterol.2022 May 1;117(5):740-747.
[11] Lin Y,Yang M, Cao J, Zhang X, Mi N, Yang X, Wang H, Gao L, Bai M,Fu W,Li X,Yue P,Yuan J, Meng W,Leung JW. Saline irrigation for reducing the recurrence of common bile duct stones after lithotripsy: a randomized controlled trial. EClinicalMed icine.2023 Apr 27;59:101978.
[12] 唐涛,李伟平.鼻胆管冲洗对ERCP术后胆总管结石复发的影响[J].中国现代医生,2013,51(6):146-148.
[13] 李积强,齐清会,张桂信.清热利胆颗粒预防腹腔镜联合胆道镜术后胆总管结石复发的效果分析 [J].临床肝胆病杂志,2023,39(10):2413-2420.
[14] 施颖琦,沈美琴,仇建伟.胆宁片等3种药物预防ERCP术后胆总管结石复发的效果比较[J].中国药房,2023,34(15):1874-1878.
[15] 周璧芸,王丹丹,付鹏飞,等.熊去氧胆酸预防ERCP取石后胆总管结石 复发疗效的Meta分析[J].现代消化及介入诊疗,2023,28(07):882-887.
[16] Kozyk M,Giri S,Harindranath S,Trivedi M, Strubchevska K, Barik RK, Sundaram S. Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review.DEN Open.2023 Oct 8;4(1):e294.
[17] Manes G,Paspatis G,Aabakken L,.Endoscopic manageme nt of common bile duct stones: European Society of Gastrointe stinal Endoscopy(ESGE)guideline.Endoscopy.2019 May;51(5):472-491.
[18] Lin YY, Wang YD, Yue P, Zhang XZ, Leung JW, Jiao PP, Yang M, Wang HP, Bai B, Liu Y, Zhang JD, Chen HB, Meng WB, Li X. Could saline irrigation clear all residual common bile duct stones after lithotripsy? A self-controlled prospective cohort study. World J Gastroenterol.2021Jan28;27(4):358-370.
[2] 林延延.盐水冲洗预防ERCP术后胆总管结石复发的临床研究及胆道微环境在复发性胆总管结石成石过程中的作用探索[D].兰州大学,2023.
[3] KimDI,KimMH,Lee SK,et al.Risk factors for recurrence of primary bile duct stones after endoscopic biliary sphinct erotomy[J].Gastrointest Endosc,2001,54(1):42-48.
[4] Kim KY,Han J,Kim HG,et al.Late complications and stone recurrence rates after bile duct stone removal by endoscopic sphincterotomy and large balloon dilation are similar to those after endoscopic sphincterotomy alone[J].Clin Endosc,2013, 46(6):637-642.
[5] Lujian P,Xianneng C,Lei Z.Risk factors of stone recurre nce after endoscopic retrograde cholangiopancreatography for common bile duct stones[J].BMC Med,2020,99(27):e20412.
[6] Wu Y,Zhang Y,Jiang XM,et al.Risk factors for single and multiple recurrences for endoscopic retrograde cholangiopan creatography and open choledochotomy in treating choledoc holithiasis[J].Gastroenterol Res Pract,2023,2023:4738985.
[7] Deng F,Zhou M,Liu PP,et al.Causes associated with recur rent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography: A large sample sized retrospective study[J].World J Clin Cases,2019,7(9):1028-1037.
[8] Park BK, Seo JH, Jeon HH, Choi JW, Won SY, Cho YS, Lee CK, Park H, Kim DW. A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea. J Gastroenterol.2018;53:670–678.
[9] Deng F, Zhou M, Liu PP, Hong JB, Li GH, Zhou XJ, Chen YX. Causes associated with recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancre atography: A large sample sized retrospective study. World J Clin Cases.2019May6;7(9):1028-1037.
[10] Wang X, Wang X, Sun H, Ren G, Wang B, Liang S, Zhang L, Kang X, Tao Q, Guo X, Luo H, Pan Y. Endoscopic Papillary Large Balloon Dilation Reduces Further Recurrence in Patients With Recurrent Common Bile Duct Stones: A Randomized Controlled Trial.Am J Gastroenterol.2022 May 1;117(5):740-747.
[11] Lin Y,Yang M, Cao J, Zhang X, Mi N, Yang X, Wang H, Gao L, Bai M,Fu W,Li X,Yue P,Yuan J, Meng W,Leung JW. Saline irrigation for reducing the recurrence of common bile duct stones after lithotripsy: a randomized controlled trial. EClinicalMed icine.2023 Apr 27;59:101978.
[12] 唐涛,李伟平.鼻胆管冲洗对ERCP术后胆总管结石复发的影响[J].中国现代医生,2013,51(6):146-148.
[13] 李积强,齐清会,张桂信.清热利胆颗粒预防腹腔镜联合胆道镜术后胆总管结石复发的效果分析 [J].临床肝胆病杂志,2023,39(10):2413-2420.
[14] 施颖琦,沈美琴,仇建伟.胆宁片等3种药物预防ERCP术后胆总管结石复发的效果比较[J].中国药房,2023,34(15):1874-1878.
[15] 周璧芸,王丹丹,付鹏飞,等.熊去氧胆酸预防ERCP取石后胆总管结石 复发疗效的Meta分析[J].现代消化及介入诊疗,2023,28(07):882-887.
[16] Kozyk M,Giri S,Harindranath S,Trivedi M, Strubchevska K, Barik RK, Sundaram S. Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review.DEN Open.2023 Oct 8;4(1):e294.
[17] Manes G,Paspatis G,Aabakken L,.Endoscopic manageme nt of common bile duct stones: European Society of Gastrointe stinal Endoscopy(ESGE)guideline.Endoscopy.2019 May;51(5):472-491.
[18] Lin YY, Wang YD, Yue P, Zhang XZ, Leung JW, Jiao PP, Yang M, Wang HP, Bai B, Liu Y, Zhang JD, Chen HB, Meng WB, Li X. Could saline irrigation clear all residual common bile duct stones after lithotripsy? A self-controlled prospective cohort study. World J Gastroenterol.2021Jan28;27(4):358-370.
Copyright © 2024 聂钱, 王子文
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License