ERCP治疗高龄胆总管结石的疗效及对患者血清CA19-9和炎症水平的影响

目的探讨分析内镜逆行胰胆管造影(ERCP)治疗高龄胆总管结石疗效及对患者血清CA19-9、炎症水平的影响。方法选择2017年3月—2018年5月宁波市第二医院收治的高龄胆总管结石患者95例,根据患者及其家属意愿,其中行ECRP取石术患者61例作为观察组,行外科手术治疗患者34例作为对照组,对比分析2组患者取石成功率、手术相关指标、并发症发生情况及手术前后血清CA19-9、炎症水平变化。结果观察组患者取石成功率为93. 44%,对照组患者腹腔镜胆总管取石成功率为97. 05%,2组取石成功率比较差异无统计学意义(P> 0. 05);观察组患者手术时间、术后卧床时间、住院时间显著短于对照组(均P <0. 05),2组抗感染治疗时间、腹痛缓解时间以及黄疸消退一半时间比较,差异无统计学意义(均P> 0. 05);观察组患者术后总并发症发生率显著低于对照组(P <0. 05)。术后3 d 2组患者血清CA19-9水平均较术前显著降低(均P <0. 05),且术后3 d观察组患者血清CA19-9水平显著低于对照组(P <0. 05)。结论 ERCP治疗高龄胆总管结石对患者机体创伤小、术后恢复快、并发症少,且取石成功率良好,并能有效降低患者术后炎症水平及血清CA19-9水平,值得临床推广运用。

Curative effect of endoscopic retrograde cholangiopancreatography on elderly patients with choledocholithiasis and its effect on level of serum CA19-9 and inflammatory

Objective To investigate the curative effect of endoscopic retrograde cholangiopancreatography (ERCP) on elderly patients with choledocholithiasis and its effect on the levels of serum cancer antigen 19-9 (CA 19-9) and inflammatory. Methods Total 95 elderly patients with choledocholithiasis admitted to Ningbo Second Hospital from March2017 to May 2018 were selected. According to the wishes of the patients and their families, 61 patients underwent ECRP lithotripsy were assigned into the observation group and 34 patients underwent surgical treatment into the control group.The success rate of lithotripsy and the related surgical indicators of the two groups were compared and analyzed. The incidence of complications and changes of serum CA19-9 and inflammatory level before and after operation were observed. Results The success rate of stone extraction was 93.44% in the observation group and 97.05% in the control group.There was no significant difference in the success rate of the two groups (P > 0.05). The operation time, the time lying in bed and the time of hospitalization in the observation group were significantly shorter than those of the control group (all P < 0.05). There was no significant difference between the two groups of anti-infection treatment time, abdominal pain relief time and the general time of jaundice regression (all P > 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P < 0.05). The average levels of serum CA19-9 three days after the operation decreased significantly when compared with that before operation (all P < 0.05), and the serum CA19-9 level three days after the operation in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion ERCP for the elderly choledocholithiasis is an effective method, with small body trauma, faster recovery, less complications, and good success rate of stone removal. It can effectively reduce the level of postoperative inflammation and the level of serum CA19-9. It is worthy of clinical application.