负压引流器及改良引流技术用于ERCP术后鼻胆管引流的临床研究

目的:观察负压引流器及改良引流技术在ERCP术后鼻胆管引流中的临床价值。 方法:选择100例行ERCP患者进行前瞻性研究，按随机数字表分为观察组与对照组，各50例。观察组采用负压引流器联合改良引流技术，对照组应用常规留置引流袋进行引流并予常规引流护理。比较两组每日引流量、导管堵塞发生率、住院时间、住院费用、术后并发症（包括高淀粉酶血症、胆管炎、胰腺炎等）总发生率、不适反应与导管不良事件总发生率。 结果:观察组每日引流量显著高于对照组（P<0.05）；观察组导管堵塞发生率、住院时间、住院费用显著低于对照组（P<0.05）。两组胆管炎与胰腺炎发生率未见统计学意义（P>0.05）；观察组高淀粉酶血症与并发症总发生率分别为12.00%与14.00%，显著低于对照组的28.00%与40.00%（P<0.05）。观察组不适反应与导管不良事件总发生率为4.00%，显著低于对照组的22.00%（P<0.05）。 结论:ERCP术后采用负压引流器进行鼻胆管引流，可获得理想引流效果，降低导管堵塞率，减少术后并发症与不适症状，改良引流技术还可进一步降低导管脱出率，确保引流通畅，可加速患者恢复，使住院时间缩短。

Clinical study of negative pressure drainage device and improved drainage technique for nasobiliary drainage after ERCP

Abstract: Objective To investigate the clinical value of negative pressure drainage device and improved drainage technique in nasobiliary drainage after endoscopic retrograde cholangio-pancreatography (ERCP). Methods A total of 100 cases of patients receiving ERCP were selected for prospective study and randomly divided into observation group and control group, with 50 cases in each group. The patients in observation group were treated with negative pressure drainage device combined with improved drainage technique, while those in control group received conventional indwelling drainage bag for drainage and conventional drainage care. The daily drainage volume, incidence of catheter occlusion, hospital stay, hospitalization expenses, the total incidence of postoperative complications (including hyperamylasemia, cholangitis, pancreatitis, etc.), adverse reactions and catheter adverse events in the two groups were compared. Results Compared with control group, observation group had significantly larger daily drainage volume (P<0.05). The incidence of catheter occlusion, hospital stay and hospitalization expenses in observation group were significantly lower than those in control group (P<0.05). No statistical significance was found between two groups in the incidence of cholangitis and pancreatitis (P>0.05). The total incidences of hyperamylasemia and complications in observation group were 12.00% and 14.00%, respectively, significantly lower than 28.00% and 40.00% in control group (P<0.05). The total incidence of adverse reactions and catheter adverse events in observation group was 4.00%, significantly lower than 22.00% in control group (P<0.05). Conclusion Negative pressure drainage device for nasobiliary drainage after ERCP can achieve an ideal drainage effect, lower the rate of catheter occlusion, and reduce postoperative complications and adverse reactions. Moreover, the improved drainage technique can further decrease the incidence of catheter falling out and ensure a smooth drainage, which can accelerate recovery and shorten hospital stay.