超细胃镜在胆管疾病诊治中的应用效果

目的 探讨超细胃镜在胆管疾病诊治中的应用价值。方法 以2013年2月至2015年2月河南大学第一附属医院接受胃镜检查的60例胆管疾病患者为研究对象，随机双盲法将其分为十二指肠镜组（36例）与超细胃镜组（24例），比较两组患者围检查期生命体征变化、反应分级，同时观察记录超细胃镜插镜情况及检查结果。结果 超细胃镜组24例一次性操作成功率100.0%，进镜视野A级占95.8%。3例超细胃镜直视下活检证实为腺瘤恶性病变，12例巨大嵌顿直视下激光碎石成功，3例疑似残余结石通过单纯胆总管探查排除结石残留。无胆管炎等并发症发生。超细胃镜组患者检查中收缩压为（96.40±9.18）mmHg，血氧饱和度为（97.85±1.37）%，优于十二指肠镜组的（103.42±10.74）mmHg、（95.71±3.05）%，差异均有统计学意义（P<0.05）；超细胃镜与十二指肠镜检查，患者反应分级差异无统计学意义（P>0.05）。结论 超细胃镜作为经口胆道镜诊治胆管疾病安全可行。

Application of ultrafine gastroscope in bile duct diseases

Objective To investigate the application value of ultrafine gastroscope in the diagnosis and treatment of bile duct diseases. Methods Sixty patients with bile duct diseases treated in our hospital from February 2013 to February 2015 were treated as the research object, including 36 cases by duodenoscopy and 24 cases by ultrafine gastroscope. The changes of vital signs and reaction grading were compared between the two groups. Meanwhile, the condition of inserting ultrafine gastroscope and the examination results were observed and recorded. Results The success rate of one-time operation in 24 cases taking ultrafine gastroscope as peroral choledochoscope was 100.0%; grade A visual field of the lens accounted for 95.8%. Three cases were confirmed with adenoma malignant lesions by biopsy under direct vision of ultrafine endoscope; under direct vision of 12 cases of huge incarcerates, laser lithotripsy was successful; three cases of suspected residual stones were removed through simplex common bile duct exploration. There were no complications such as cholangitis. The differences of ultrafine gastroscope in the examination of patients with systolic pressure of (96.40±9.18) mmHg, oxygen saturation of (97.85±1.37)% were statistically significant, compared with those of duodenoscopy group[(103.42±10.74) mmHg, (95.71±3.05)% respectively](P<0.05). There was no significant difference in reaction grading between ultrafine gastroscopy and duodenoscopy(P>0.05). Conclusion Ultrafine gastroscope as peroral choledochoscope is safe and feasible in the diagnosis and treatment of bile duct diseases.