内镜治疗80岁以上高龄胆总管结石患者的价值

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目的:探讨高龄(≥80岁)胆总管结石患者内镜治疗的有效性和安全性。方法:回顾性分析2014年1月—2017年12月南京大学医学院附属鼓楼医院内镜中心行经内镜逆行胰胆管造影术(ERCP)治疗的742例胆总管结石患者资料,其中≥80岁的患者(高龄组)196例,≤60岁的患者(非高龄组)546例。采用1∶1倾向性评分匹配法对两组患者性别、结石数目、结石大小进行基线资料匹配,获得组间协变量均衡样本。成功匹配196对患者。对比两组患者治疗成功率、并发症发生率、住院时间、住院费用等指标。结果:胆总管结石高龄组患者合并疾病者明显高于非高龄组[93.4%(183/196)比76.5%(150/196),n P0.05)。n 结论:ERCP有效性和安全性高,可作为高龄胆总管结石患者的首选治疗方式。“,”Objective:To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for the elderly patients (80 years or older) with choledocholithiasis.Methods:A retrospective study was conducted on 742 cases of choledocholithiasis who underwent ERCP at Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 2014 to December 2017. The patients were divided into two groups: 196 patients aged 80 or above (the very elderly group) and 546 patients aged 60 or below (the non-elderly group). The baseline data including gender, number and size of stones of the two groups were matched using the 1∶1 propensity score matching, and the covariate equalization samples between the two groups were obtained and 196 pairs of patients were successfully matched. The treatment success rate, complication incidence, hospitalization time and cost were analyzed.Results:Comorbidities in patients of the elderly group were significantly more than those in the non-elderly group [93.4% (183/196) VS 76.5% (150/196), n P0.05).n Conclusion:ERCP is effective and safe, and can be used as the first choice for senile patients with choledocholithiasis.
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