ERCP对胆管狭窄的诊断价值

目的探讨经内镜逆行胰胆管造影(ERCP)在梗阻性黄疸诊断中的应用价值。方法回顾性分析2009年1月至2011年1月在北京军区总医院消化内科住院治疗的172例梗阻性黄疸的临床资料,对比较B超、CT、磁共振胰胆管造影(MRCP)、ERCP对梗阻性黄疸病因诊断的正确率。结果四种检查正确率由高到低依次为ERCP、MRCP、CT、超声,其中超声的诊断率最低,与其他3种比较差异均有统计学意义(P<0.05);ERCP的正确率优于MRCP,但两者比较差异无统计学意义(P>0.05)。43例患者均行胆管细胞刷片活检,结果显示:胆管细胞刷片活检对于良、恶性胆关系狭窄的鉴别差异有统计学意义(χ2=9.68,P<0.05)。结论 ERCP技术以其创伤小,安全有效等特点成为梗阻性黄疸微创治疗的首选。

The Value of ERCP for the Diagnosis of Obstructive Jaundice

Objective To explore the practical value of ERCP in the diagnosis of obstruetive jaundice. Methods The clinical reports of 172 cases of inpatients with obstructive jaundice admitted in the department of gastroenterology, General Hospital of Beijing Military Region from Jan. 2009 to Jan. 2011 were retrospectively analyzed. And the diagnostic accuracy of type-B ultrasonic cheek, CT,magnetic resonance eholangiopancreatography（MRCP） ,and ERCP in the diagnosis of obstructive janndieewere compared. Results It was revealed that the diagnostic accuracy of the four diagnostic methods,from high to low were ERCP,MRCP, CT,and ultrasonagTaphy. The difference between the lowest accuracy of ultrasonic with the other three methods was statistically significant（P 〈0.05）. Although the accuracy of ERCP was higher than MRCP,the difference between the two was not statistically significant （P 〉 0. 05 ）. A total of 43 patients with suspected malignant biliary stricture who had been treated with ERCP examination were also checked by Biliary cells brushing biopsy. The results suggested that ：the diagnostic accuracy of biliary cells brushing biopsy in diagnosing benign and malignant biliary stenosis had statistically significant differences（χ2 =9.68,P 〈0.05）. Conclusion Compared with other imaging methods ,ERCP becomes the first choice in the diagnosis of obstructive jaundice due to its incomparable advantages of causing little trauma,safe and effeetive,etc.