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血管造影导丝在肝内胆管超选择性插管中的应用 被引量:1

Application of angiographic guidewire in intrahepatic bile duct super-selective intubation
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摘要 目的评价弯头型血管造影导丝(泥鳅导丝)与超亲水性软头导丝(黄斑马导丝)用于经内镜逆行胰胆管造影(ERCP)中肝内胆管超选择性插管的效果。方法选取2015年1月至2016年6月需要进行肝内胆管选择性插管的100例患者为研究对象,采用随机数字表法分为泥鳅导丝组(切开刀+弯头型血管造影导丝超选择性插管)和黄斑马导丝组(切开刀+黄斑马导丝超选择性插管)各50例。如果5 min肝内胆管超选择性插管不成功,则交换另一种方法重新超选择插管。观察肝内胆管超选择性插管时间、插管成功率以及术后患者体温及血清胆红素的变化情况。结果黄斑马导丝组5 min内肝内超选择性插管成功率30例,不成功病例换血管造影导丝均在5 min内超选择性插管成功。泥鳅导丝组50例,5 min内全部超选择性插管成功。泥鳅导丝组肝内胆管超选择性插管时间明显短于黄斑马导丝组[(83.34±11.79)s vs(349.32±43.40)s,P〈0.01],插管成功率明显高于黄斑马导丝组(100.00%vs 60.00%,P〈0.01),差异均有统计学意义。结论与黄斑马导丝比较,作为血管造影的泥鳅导丝可缩短肝内胆管超选择性插管时间,提高肝内胆管超选择性插管成功率。 Objective To investigate the effect of curve-top guidewire(loach guidewire) and ultra-smooth hydrophilic guidewire(zebra guidewire) in super-selective intubation of intrahepatic bile duct in endoscopic retrograde cholangiopancreatography(ERCP). Methods A total of 100 patients who needed selective intubation of intrahepatic bile duct from January 2015 to June 2016 were selected as study object,and they were divided into loach guidewire group and zebra guidewire group by random digits table method(50 cases each). If the intrahepatic bile duct super-selective intubation was not successful in 5 min,exchanged another method to do the intubation. The time of intrahepatic bile duct super-selective intubation,the success rate of intubation,and the change of body temperature and serum bilirubin in patients after operation were observed. Results There were 30 cases intubated successfully in 5 min in the 50 cases patients of zebra guidewire,and the rest cases were successful in 5 min afther changed the angiographic guidewire. All the 50 cases in loach guidewire group intubated successfully in 5 min. Compared with zebra guidewire group,the loach guidewire group had a shorter intubation time[(83. 34 ± 11. 79) s vs(349. 32 ± 43. 40) s,P〈0. 01],and a higher success rate of intubation(100. 00% vs 60. 00%,P〈0. 01). Conclusion Compared with zebra guidewire,loach guidewire as angiography shorten the intubation time and improve the success rate of intrahepatic bile duct super-selective intubation.
作者 周晓亮 蔡薇 秦争艳 葛靖 李雯 ZHOU Xiao-liang, CAI Wei, QIN Zheng-yan, GE Jing, LI Wen(Endoscopy Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China)
出处 《中国临床研究》 CAS 2018年第3期407-409,共3页 Chinese Medicine of Factory and Mine
关键词 经内镜逆行胰胆管造影 肝内胆管超选择性插管 弯头型血管造影导丝 超亲水性软头导丝 Endoscopic retrograde cholangiopancreatography Super-selective intubation, intrahepatic bile duct Curvetop guidewire Ultra-smooth hydrophilic guidewire
作者简介 通讯作者:李雯,E-mail:liwennj@live.cn
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