临床应用内镜治疗化脓性胆管炎的研究

目的 采用探讨内镜治疗急性化脓性胆管炎的临床疗效。方法 对35例化脓性胆管炎患者急诊ERCP检查和治疗，其胆管结石23例；乳头狭窄及功能异常4例；胆管管损伤后狭窄2例；恶性肿瘤6例。胆总管结石的治疗：ERCP检查明确为胆总管结石，如患者生命体征平稳，则予急诊取石。十二指肠乳头炎性狭窄和功能异常的治疗可选择ES或乳头括约肌球囊扩张。胆管恶性梗阻的治疗：使用胆管扩张探条沿导丝插入予以扩张后再放置引流管进行治疗。结果 35例急性胆囊炎患者中31例完成治疗，成功率93．84％。经内镜治疗后48h内，26例患者腹痛缓解，体温下降，急性胆囊炎症状均得到有效控制。23例胆管结石，急诊行取石术或同时放ENBD，取出全部结石。十二指肠乳头狭窄或功能异常4例，3例行E卵治疗，急性胆管炎得到控制。结论 急性化脓性胆管炎，无论是胆管结石还是良恶性狭窄所致，均可以选择内特引流，可减轻患者痛苦、缩短住院时间、减少费用。

Study on Clinical Application of Endoscope for Treatment of Suppurative Cholangitis

Objective To discuss the clinical application of endoscope for treatment of suppurative cholangitis. Methods 35 cases of such patient were detected with ERCP and treated among them there were 23 eases of gallstone, 4 cases of papillary stenosis andabnormal function, 2 cases of bile duct injury stenosis and 6 cases of malignant tumor. The gallstone was treated with operation. Papillary stenosis and abnormal function was treated with ES or dilation of sphincter muscle. The malignant tumor was treated with dilation and placing drainage tube. Results 31 of 35 eases were underwent treatment with successful rate of 93.84%. 26 eases were relieved within 48 h with endoscope and gained better symptom controh 23 eases gallstone were performed emergency operation and ENBD. 3 of 4 abnormal function were performed with EST. Conclusion The SC might be treated with endoscope whether it is benign or malignant that could reduce pain, shorten hospitalization and less paymem.