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| 1 | 经内镜逆行胰胆管造影术治疗高龄胆总管结石疗效观察及安全性评估显示文摘目的研究经内镜逆行胰胆管造影术(ERCP)治疗高龄胆总管结石疗效观察及安全性。方法将高龄胆总管结石患者纳入研究,根据手术方法不同分为给予治疗性经内镜逆行胰胆管造影术治疗的内镜组和给予胆总管切开取石的外科手术组,比较两组患者的治疗情况、炎症反应以及并发症情况。结果两组取石成功率比较差异无显著性(97.5%VS 95.0%);内镜组患者手术时间(28.6±12.9)min、腹痛缓解时间(1.2±0.3)d、黄疸消退时间(2.1±0.4)d、术后卧床时间(1.4±0.3)d、抗感染治疗时间(1.5±0.3)d、住院时间(6.6±0.4)d、TNF-α(2.1±0.3)μg/L、IL-1(6.4±0.9)μg/L、IL-6(2.8±0.4)μg/L、并发症(1.8%)均明显低于外科手术组(P<0.05)。结论经内镜逆行胰胆管造影术治疗有助于控制创伤、促进恢复、缓解炎症反应、减少并发症,是胆总管结石较理想的治疗方法。 | 张锎 丁辉 李芸 | 2015 | 中国内镜杂志2015，21，3： | 35 |
| 2 | 毕Ⅱ式胃大部切除术后经内镜逆行胰胆管造影临床疗效及辅助技术新进展显示文摘毕Ⅱ式ERCP是指对毕Ⅱ式胃大部切除术后胆胰疾病患者进行的ERCP,属第5级高难度ERCP操作。胃肠道正常解剖结构的改变,一定程度上增加了内镜操作的难度,要求内镜医师不仅要具备娴熟的操作技能和丰富的临床经验,还要熟悉毕Ⅱ式术后的解剖结构,正确辨别输入袢。 | 李家速 刘枫 李兆申 | 2017 | 中华消化内镜杂志2017，34，9： | 8 |
| 3 | 双气囊小肠镜在临床应用中的研究进展显示文摘自双气囊小肠镜(DBE)问世后,因其具有可对整个小肠进行直视下的观察、可控性强的特点,对多种小肠相关疾病具有较高的诊断率,并可进行局部止血治疗(包括氩气凝固、电灼、止血夹夹闭等方法)、对狭窄处进行扩张治疗、镜下息肉切除术等方法,在临床应用中具有独特的优势。与其他检查方法相比,DBE在不明原因消化道出血的诊治过程中更具优势,在克罗恩病的诊断、病情评估及治疗方案的调整方面具有重要作用,不仅可以在直视下评估肠道黏膜的愈合程度,而且可以指导治疗方法从而使克罗恩病患者达到持续的临床缓解。在小肠肿瘤的、小肠息肉及其他小肠疾病的诊治方面也具有独特的优势,不仅可以对小肠肿瘤进行直视下的观察以提高诊断率,而且可以取组织活检指导治疗方法,提高小肠息肉的诊断率。 | 施琦 徐洪雨 | 2017 | 医学综述2017，23，3： | 5 |
| 4 | Immediate detection of endoscopic retrograde cholangiopancreatographyrelated periampullary perforation: Fluoroscopy or endoscopy?显示文摘AIM:To investigate the causes and intraoperative detection of endoscopic retrograde cholangiopancreatography(ERCP)-related perforations to support immediate or early diagnosis.METHODS:Consecutive patients who underwent ERCP procedures at our hospital between January2008 and June 2013 were retrospectively enrolled in the study(n=2674).All procedures had been carried out using digital fluoroscopic assistance with the patient under conscious sedation.For patients showing alterations in the gastrointestinal anatomy,a short-type double balloon enteroscope had been applied.Cases of perforation had been identified by the presence of air in or leakage of contrast medium into the retroperitonealspace,or upon endoscopic detection of an abdominal cavity related to the perforated lumen.For patients with ERCP-related perforations,the data on medical history,endoscopic findings,radiologic findings,diagnostic methods,management,and clinical outcomes were used for descriptive analysis.RESULTS:Of the 2674 ERCP procedures performed during the 71-mo study period,only six(0.22%)resulted in perforations(male/female,2/4;median age:84 years;age range:57-97 years).The cases included an endoscope-related duodenal perforation,two periampullary perforations related to endoscopic sphincterotomy,two periampullary perforations related to endoscopic papillary balloon dilation,and a periampullary or bile duct perforation secondary to endoscopic instrument trauma.No cases of guidewire-related perforation occurred.The video endoscope system employed in all procedures was only able to immediately detect the endoscope-related perforation;the other five perforation cases were all detected by subsequent digital fluoroscope applied intraoperatively(at a median post-ERCP intervention time of 15 min).Three out of the six total perforation cases,including the single case of endoscope-related duodenal injury,were surgically treated;the remaining three cases were treated with conservative management,including trans-arterial embolization to control the bleeding in one of the cases.All patients recovered without further incident.CONCLUSION:ERCP-related perforations may be difficult to diagnose by video endoscope and digital fluoroscope detection of retroperitoneal free air or contrast medium leakage can facilitate diagnosis. | Yasuaki Motomura Kazuya Akahoshi Junya Gibo Kenji Kanayama Shinichiro Fukuda Shouhei Hamada Yoshihiro Otsuka Masaru Kubokawa Kiyoshi Kajiyama Kazuhiko Nakamura | 2014 | World Journal of Gastroenterology2014，20，42： | 5 |
| 5 | 80岁以上患者行内镜逆行胰胆管造影术围术期护理显示文摘目的:探讨80岁以上患者行内镜逆行胰胆管造影术(ERCP)的围术期护理策略。方法:分析35例80岁以上患者行ERCP围术期临床资料,总结有效护理策略。结果:本组35例患者中,成功完成手术33例,成功率94.29%;术后发生并发症3例,发生率8.57%,其中急性胰腺炎1例、消化道出血1例、胆道感染1例,经过积极对症治疗后均治愈,未发生因护理不当引起的并发症。结论:术前充分评估、积极准备,术中配合娴熟、严密观察,术后细致观察、积极护理,围术期护理保证了80岁以上患者ERCP手术成功。 | 陈佩 毛鑫群 | 2018 | 齐鲁护理杂志2018，24，6： | 1 |
| 6 | Accuracy of carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography using double-balloon endoscopy显示文摘BACKGROUND Retrograde cholangiopancreatography using double-balloon endoscopic retrograde cholangiography(DBERC)is a valuable technique to treat biliary stone and jejunobiliary anastomotic stenosis in patients with altered gastrointestinal anatomy.The accurate selection of the route at the anastomosis branch is one of the most important factors in reaching the target in a timely manner.AIM To determine the accuracy of carbon dioxide insufflation enterography(CDE)at the branch for selecting the correct route during DBERC.METHODS We enrolled 52 consecutive patients scheduled for DBERC at our institution from June 2015 to November 2017.Route selection via two methods(visual observation and CDE)was performed in each patient.We determined the correct rate of route selection using CDE.RESULTS Thirty-three patients had a jejunojejunal anastomosis and 19 patients had a gastrojejunal anastomosis.The therapeutic target region was reached in 50 patients.The mean procedure times from the teeth to the target(total insertion time),from the teeth to the branch,and from the branch to the target,and the mean total examination time were 15.2,5.0,8.2,and 60.3 min,respectively.The rate of correct route selection using visual observation and CDE were 36/52(69.2%)and 48/52(92.3%),respectively(P=0.002).The rate of correct route selection using CDE in patients with a jejunojejunal anastomosis was 29/33(87.8%),and the rate in patients with a gastrojejunal anastomosis was 19/19(100%).CONCLUSION CDE is helpful in selecting the route at the branch in the anastomosis for more timely access to the target in patients with altered gastrointestinal anatomy undergoing DBERC. | Yoshiki Niwa Masanao Nakamura Hiroki Kawashima Takeshi Yamamura Keiko Maeda Tsunaki Sawada Yasuyuki Mizutani Eri Ishikawa Takuya Ishikawa Naomi Kakushima Kazuhiro Furukawa Eizaburo Ohno Takashi Honda Masatoshi Ishigami Mitsuhiro Fujishiro | 2020 | World Journal of Gastroenterology2020，26，42： | 1 |
| 7 | 调整ERCP术后病人卧位睡姿的效果观察显示文摘[目的]探讨内镜下进行胰胆管造影(ERCP)术后调整病人卧位睡姿在临床护理中的意义。[方法]筛选2016年2月—5月在某医院普外科诊断为胆管结石接受ERCP治疗的病人136例。按照随机对照原则分为试验组和对照组,各68例。试验组术后进行睡姿调整,对照组病人不进行睡姿调整,观察两组病人手术完毕到出院前的血尿淀粉酶、24h睡眠时间、24h胆汁排出量、术后到正常进食时间及术后留院时间等。[结果]术后第1周,试验组病人的血淀粉酶低于对照组,差异有统计学意义(P<0.05);试验组病人术后第1周24h胆汁排出量达到正常,排出量高于对照组,差异有统计学意义(P<0.05),对照组24h胆汁排出量在术后达到正常,高于试验组,差异有统计学意义(P<0.05);术后2周,试验组病人的24h睡眠时间高于对照组,差异有统计学意义(P<0.05),试验组中手术结束到术后正常进食时间短于对照组,差异有统计学意义(P<0.05)。[结论]对胆管结石ERCP术后病人进行睡姿调节及睡眠指导可促进病人康复,并提高病人护理满意度。 | 陈沛 邱玥 张灿 周慧勤 | 2018 | 循证护理2018，4，2： | 0 |
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