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[1]姜海波,王俊梅,刘贯华.ERCP治疗胆总管结石合并肝硬化的效果分析[J].天津医科大学学报,2018,24(02):162-164,169.
 JIANG Hai-bo,WANG Jun-mei,LIU Guan-hua.Effect of ERCP in the treatment of common bile duct stones complicated with cirrhosis[J].Journal of Tianjin Medical University,2018,24(02):162-164,169.
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ERCP治疗胆总管结石合并肝硬化的效果分析(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
24
期数:
2018年02期
页码:
162-164,169
栏目:
论著(临床医学)
出版日期:
2018-03-20

文章信息/Info

Title:
Effect of ERCP in the treatment of common bile duct stones complicated with cirrhosis
作者:
姜海波王俊梅刘贯华
郑州人民医院内镜诊疗区 , 郑州450053
Author(s):
JIANG Hai-bo WANG Jun-mei LIU Guan-hua
Endoscopy Diagnosis Area, People’s Hospital of Zhengzhou , Zhengzhou 450053, China
关键词:
逆行胆胰管造影术胆总管结石肝硬化肝功能
Keywords:
retrograde cholangiopancreatography choledocholithiasis cirrhosis liver function
分类号:
R575.7
DOI:
-
文献标志码:
A
摘要:
目的:探讨逆行胆胰管造影术(ERCP)治疗胆总管结石合并肝硬化患者的临床效果及对患者肝 功能的影响。方法:对实施ERCP手术治疗的122例胆总管结石合并肝硬化患者进行回顾性研究,观察取石 成功率、治疗前后患者的肝功能等指标变化。结果:其中120例患者均成功完成取石手术,2例患者因合 并Mirizzi综合征,转开腹手术治疗,手术成功率为98.36%。术后2周,120例患者的谷丙转氨酶(ALT) 、谷草转氨酶(AST)、直接胆红素(DBIL)、白蛋白(ALB)、终末期肝病(MELD)评分较术前均显著 降低(P<0.05);术后7 d,患者的血清肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-1β(IL-1β)、IL-6 、MCP-1、高迁移率簇蛋白-1(HMGB-1)水平逐渐恢复至术前水平;Child-pugh分级A级患者并发症发生 率为4.35%、B级患者的并发症发生率为7.69%、C级患者的并发症发生率为41.67%,肝功能C级患者采用 ERCP治疗的并发症率较高(χ2=21.625,P<0.001)。结论:ERCP治疗胆总管结石合并肝硬化患者取石效 果较好,成功率高,术后患者肝功能及炎症应激反应可较快恢复,但是对于肝功能C级患者手术并发症发 生率较高。
Abstract:
Objective: To investigate the clinical effect of retrograde cholangiopancreatography (ERCP) in the treatment of patients with common bile duct stones and liver cirrhosis. Methods: One hundred and twenty two cases of patients with common bile duct stones combined with cirrhosis were treated by ERCP operation. The success rate of stone extraction and the changes of liver function were observed before and after treatment. Results: Among them, 120 patients successfully undergone stone removal surgery, and the patients with Mirizzi syndrome were converted to open surgery, and the operation power was 98.36% in the treatment of the patients with the syndrome. Two weeks after surgery, for 120 cases of patients with complete ERCP operation, ALT, AST, DBIL, ALB, MELD scores were significantly lower than those before surgery (P<0.05); 7 days after operation, the serum TNF-α, IL-6, IL-1 beta, MCP-1, HMGB-1 levels gradually recovered to the preoperative level; for grade A in patients with Child-pugh, the complication rate was 4.35%, the complication rate was 7.69% for patients with grade B; for patients with grade C, the complication rate was 41.67%, and C grade of liver function in patients with complications of ERCP was higher (χ2=21.625, P<0.001). Conclusion: ERCP treatment for stone choledocholithiasis patients with cirrhosis of the liver, can bring high success rate and better results, postoperative liver function and inflammatory reaction can be recovered, but for patients with liver function C grade, complication rate may be higher.

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备注/Memo

备注/Memo:
文章编号 1006-8147(2018)02-0162-03
作者简介 姜海波(1975-),男 ,副主任医师, 学士, 研究方向:消化内镜:E-mail:gcy7703@163.com。
更新日期/Last Update: 2018-03-20