目的 研究选择性插管对ERCP术后胰腺炎的预防作用.方法 随机抽取在我院2009年至2011年因胆系疾病行ERCP检查和治疗的212例患者,按随机数字法分成常规插管造影组(常规组)100例和导丝超选组(导丝组)112例,监测两组血清淀粉酶波动情况,统计两组ERCP术后胰腺炎(PEP)发生率,回顾性分析选择性插管和PEP发生率的关系.结果 两组插管成功率无统计学差异(P＞0.05),常规组超作时间较导丝组长,常规组PEP发生率为13％,明显高于导丝组的5.36％(P＜ 0.05),常规组有4例出现重症PEP,导丝组有3例重症PEP.结论 ERCP操作中应用导丝进行目标胆管选择性插管不能明显提高插管成功率,但能有效降低PEP发生率.%Objection To evaluate the preventive effect of selective intubation on post-ERCP pancreatitis (PEP). Methods From 2009 to 2011,212 cases underwent ERCP due to biliary disease in our hospital were divided into two groups by random number method: conventional group and selected group. The fluctuations of serum amylase were monitored, and the incidence of PEP in two groups was compared. The relationship between the incidence of PEP and the selection of intubation was analyzed, retrospectively. Result The success rate of intubation in two groups had no significant difference (P > 0.05),the operation time in conventional group was longer than in selected group. The rate of PEP in conventional group was 13%, and 5.36% in selected group (P<0.05). Four cases suffered severe PEP in conventional group, and 3 cases in selected group. Conclusions The use of guide wire in the target cannulation during ERCP could not only significantly improve the success rate of intubation, but could reduce the incidence of PEP.
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