169例高龄患者行治疗性ERCP的安全性和有效性探讨

目的通过比较不同年龄段患者内镜逆行胰胆管造影（endoscopicretrogradecholangiopancre—atography，ERCP）的应用情况，分析和探讨ERCP在高龄患者中应用的有效性和安全性。方法2010年1月～2012年12月，本院进行ERCP操作的患者169例，按年龄分组，其中≥70岁的患者（高龄组）83例，〈70岁的患者（非高龄组）86例。记录患者ASA分级、基础疾病、ERCP操作以及并发症情况，对结果进行统计分析。结果169例患者进行了181次ERCP操作。例数、性别比例在两组间差异无统计学意义（P〉0．05）。ERCP操作成功率、并发症发生率两组比较差异无统计学意义（P〉0．05）。高龄组患者ASA分级比非高龄组高，差异有统计学意义（P〈0．05）。高龄组胆道系统结石及胰腺或胆道恶性肿瘤显著高于非高龄组（P〈0．05）。结论高龄组进行ERCP操作能够取得和非高龄组一样的疗效，ERCP在高龄患者中的应用是安全、有效的。

Safety and efficacy of therapeutic ERCP in 169 elderly patients

Objective To compare the safety and efficacy of endoscopic retrograde cholangiopancre- atography （ERCP） in elderly and non-elderly patients. Methods One hundred and sixty nine patients who un- derwent ERCP between Jan. 2010 and Dec. 2012 were retrospectively studied. Eighty three patients were 70 years of old or over（elderly group） and 86 patients were 69 years of age or younger （non-elderly group）. Data about ASA degree, primary diseases, ERCP procedures, complications were recorded and compared between the two groups. Results One hundred and sixty nine cases were undergone 181 ERCP procedures. The age, sex were similar in both groups. The overall therapeutic ERCP successful rate and complication rate were simi- lar in both groups; elderly group had a higher ASA degree than non-elderly group（P 〈 0.05）; compared with patients in non-elderly group, patients in elderly group had more malignant lesions and duodenal peripapilla diverticulum, respectively（P 〈 0.05）. Conclusion Diagnostic and therapeutic ERCP have similar outcomes and complications rate in both elderly and non-elderly patients. ERCP is effective and safe in elderly patients.