胆管结石内镜下鼻胆管引流1个月后再行胆道探查术的可行性及临床疗效研究.docVIP

精品论文 参考文献 胆管结石内镜下鼻胆管引流1个月后再行胆道探查术的可行性及临床疗效研究 常德市第一人民医院消化科 湖南常德 415000 【摘 要】【目的】 探讨胆管结石内镜下鼻胆管引流（ENBD）1个月后再行胆道探查术的可行性及临床效果。【方法】 回顾性分析我院2014年1月至2014年10月32例胆管结石患者行内镜下鼻胆管引流术的临床资料。分别统计ENBD术前、术后5天和术后1个月的白细胞计数、总胆红素、谷丙转氨酶、谷草转氨酶、Na+及K+数值并进行统计学分析。【结果】 对比ENBD术前及术后5天白细胞计数、总胆红素、谷丙转氨酶、谷草转氨酶，有统计学差异（Plt;0.05）；而Na+、K+无统计学差异（Pgt;0.05）。再对比ENBD术后5天及术后1个月总胆红素、谷丙转氨酶、谷草转氨酶，有统计学差异（Plt;0.05），而Na+、K+无统计学差异（Pgt;0.05）。32例患者鼻胆管引流术后7-10天出院，引流1个月后行胆道探查术，手术成功率100%。【结论】 本组32例患者均为ENBD术后1个月再行胆总管探查术，分别于ENBD术前、术后5天及术后1个月对比血常规及血生化各项指标，白细胞、肝功能均逐渐恢复，鼻胆管引流1个月未发生电解质紊乱。因此，胆管结石内镜下鼻胆管引流术后后1个月后再行胆道探查术是可行的，疗效可靠。 【关键词】内镜下鼻胆管引流术；胆管结石；ERCP Abstract：【Objective】To discuss the feasibility and clinical effects studies of bile duct exploration 1 month after Endoscopic nasobiliary drainage（ENBD) for cholangiolithiasis.【Methods】Analyse the clinical data from 32 cases who received endoscopic nasobiliary drainage for cholangiolithiasis from January 2014 to October 2014 in our hospital.Investigate and analyse the white blood cell count，total bilirubin，glutamic-pyruvic transaminase，glutamic oxalacetic transaminase，Na+ and K+，pre-ENBD 5 days post ENBD and a month post ENBD.【Results】Comparing the the white blood cell count，total bilirubin，glutamic-pyruvic transaminase，glutamic oxalacetic transaminase before ENBD with those of 5 days after ENBD，it remained statistically difference（Plt;0.05）；but there was no statistically difference in Na+ and K+（Pgt;0.05）.And comparing the white blood cell count，total bilirubin，glutamic-pyruvic transaminase，glutamic oxalacetic transaminase of 5 days post ENBD with those 1 month post ENBD，it remained statistically difference（Plt;0.05；while there was no statistically difference in Na+ and K+（Pgt;0.05）.32 cases of patients left hospital 7-10 days after ENBD and received biliary tract surgical exploration 1 month after that，the success rate of which was 100%. 【Conclusion】Bile duct exploration 1 month after the endoscopic nasobiliary drainage for cholangiolithiasis was feasible