eslbd与est治疗老年人胆总管结石的研究

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1、授予单位代码１００８９学号或申请号巧＾（ｉ钟Ａ這ＨｅｂｅｉＭｅｄｉｃａｌＵｎｉｖｅｒｓｉｔｙ硕±学位论文在职科学学位ＥＳＬＢＤ与ＥＳＴ治巧老年人胆总管结石的研究学位申请人：李攀导师：王爱民教授专业：内科学二级学院：解放军２５２医院２０１５年１０月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完。本学位论文所获的研究成果成，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用

2、。凡一发表与学位主要内容相关的论文，第署名单位为河化医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应的法律贵任。．研究生签名；＾＾河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作双取得的研究成果，陈了文中特别加Ｗ标注等内容外，文中不包含其他人己经发表或撰写的研究成果。本论文由本人独立，指导教师对此进行了审定撰写，文责自负。研究生签名导师签章；／＾记；年月八日目录中文摘要·······················

3、·······················································1英文摘要··············································································3研究论文ESLBD与EST治疗老年人胆总管结石的研究前言··············································································5材料与方法···············

4、······················································6结果··············································································8附图··············································································11附表··············································

5、································15讨论··············································································17结论··············································································19参考文献································································

6、········19综述ESLBD与EST治疗胆总管结石·········································23致谢····················································································38个人简历··············································································39中文摘要ESLBD与EST治疗老年人胆总管结石

7、的研究摘要目的：经内镜括约肌切开术（endoscopicsphincterotomy，EST）是目前治疗胆总管结石的主要方法之一。然而单独应用EST的方法治疗胆总管多发结石或者大结石（≥12mm）较为困难。最近，越来越多的报告显示经内镜括约肌切开联合大球囊扩张（ESTplusendoscopicpapillarylarge-balloondilation，ESLBD）在治疗胆总管结石方面是有效的。本文的目的是评价ESLBD与EST在治疗老年人胆总管多发结石或者大结石的疗效，同时也比较两项技术的并发症发生率。方法：2014-03

8、/2015-03共118例老年病人，所有病人胆总管结石总数大于或者等于3枚或者胆总管结石最大直径大于或者等于12mm，采取ESLBD或者EST治疗，分为两组：ESLBD组（n=63）、EST组（n=55）。比较ESLBD组与EST组的最终取净结石成功率、第一次ERCP取石的成