ercp术后鼻胆管引流和抗生素灌洗的作用

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1、ERCP术后鼻胆管引流和抗生素灌洗的作用摘要：目的探讨鼻胆管引流和抗生素灌洗对ERCP术后并发症的影响。方法回顾性分析自2012年1月〜2015年12月共约126例ERCP患者术后放置鼻?管引流，将患者分为ENBD+甲硝哇灌洗组、ENBD+庆大霉素灌洗组、单纯ENBD组。将各组患者腹痛、发热、黄疸消退时间、血淀粉酶消退时间、胆汁引流量进行比较分析。结果126例ERCP患者术后放置鼻胆管引流，英中ENBD+甲硝哇灌洗组40例，ENBD+庆大霉素灌洗组39例，单纯ENBD组47例。三组患者的腹痛和发热症状没有明

2、显区别。ENBD+甲硝哇灌洗组和ENBD+庆大霉素灌洗组的黄疸消退时间及血淀粉酶消退时间短于单纯ENBD组，ENBD+甲硝哩灌洗组的血淀粉酶消退时间短于ENBD+庆大霉素灌洗组，两组抗生素灌洗组黄疸消退时间没有明显差异。在胆汁引流量方面，ENBD+甲硝呼灌洗组和ENBD+庆大霉素灌洗组的胆汁引流量低于单纯ENBD组，ENBD+庆大霉素灌洗组的服汁引流量低于ENBD+甲硝呼灌洗组。结论ENBD+抗生素灌洗可以促进胆总管充分引流胆汁和胰液，局部减轻胆管炎症和胰腺炎并发症。ENBD+甲硝U坐灌洗的效果可能优于EN

3、BD+庆大霉素灌洗。关键词：鼻胆管引流；内镜逆行胰胆管造影；并发症Abstract：ObjectiveTodiscusstheinfluenceofnasalbiliarydrainageandantibioticlavageonthecomplicationofendoscopicretrogradecholangio-pancreatography(ERCP)・MethodsRetrospectiveanalysisof126patientswithnasalbiliarydrainageafterER

4、CPfromJanuary2012toDecember2015.Patientsweredividedintothreegroups,suchasendoscopicnasalb订iarydrainage(ENBD)combinedwithmetronidazolelavage,endoscopicnasalbiliarydrainagecombinedwithgentamicinlavage,andendoscopicnasalbiliarydrainage.Tocomparativeanalyzethe

5、indexsuchasabdominalpain,fever,fadetimeofjaundice,fadetimeofserumamylase,andamountofbiliarydrainage.ResultsAmong126patientswithnasalbiliarydrainage,therewere40casesofendoscopicnasalbiliarydrainage(ENBD)combinedwithmetronidazolelavage,39casesofendoscopicnas

6、albiliarydrainagecombinedwithgentamicinlavage,and47casesofendoscopicnasalbiliarydrainage.Therwerenosignificantlydifferenceamongthreegroups.Thefadetimeofjaundiceanderumamylaseofendoscopicnasalbiliarydrainagecombinedwithmetronidazolelavageandendoscopicnasalb

7、iliarydrainagecombinedwithgentamicinlavagewereshorterthanendoscopicnasalbiliarydrainagealone.Thefadetimeofserumamylaseofendoscopicnasalbiliarydrainage(ENBD)combinedwithmetronidazolelavagewasshorterthanendoscopicnasalbiliarydrainagecombinedwithgentamicinlav

8、age.Therewerenosignificantlydifferenceinfadetimeofjaundicebetweentwoantibioticlavagegroups.Intheamountofbiliarydrainage,endoscopicnasalbiliarydrainagecombinedwithmetronidazolelavageandendoscopicnasalbiliarydr