中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2012年
10期
762-764
,共3页
谢飞%张洁%牟廷刚%赖良
謝飛%張潔%牟廷剛%賴良
사비%장길%모정강%뢰량
胰腺炎,急性坏死性%胆结石%胰胆管造影术,内窥镜逆行
胰腺炎,急性壞死性%膽結石%胰膽管造影術,內窺鏡逆行
이선염,급성배사성%담결석%이담관조영술,내규경역행
Pancreatitis,acute nccrotizing%Cholelithiasis%Cholangiopancreatography,endoscopic retrograde
目的 探讨急性胆源性胰腺炎早期内镜治疗的疗效及安全性.方法 将2001年1月至2012年1月本院收治的420例急性胆源性胰腺炎按治疗方式随机分为早期(48 h内)内镜下逆行胆胰管造影治疗组(ERCP组)218例及同期保守治疗组(对照组)202例.分别观察两组的腹痛缓解时间、血尿淀粉酶恢复时间、肝功能恢复时间、血白细胞计数恢复时间、平均住院天数、平均费用并观察其并发症发生情况.结果 ERCP组全部成功施行内镜下乳头括约肌切开,172例胆总管结石患者行网篮及气囊取石,218例均行内镜鼻胆管引流术,重症20例同时行胰管支架引流.ERCP组平均腹痛缓解时间及血尿淀粉酶恢复时间、肝功能恢复时间、血白细胞恢复时间、平均住院天数、平均费用均明显低于对照组.ERCP组重症病死率为8.0％,对照组重症患者病死率22.2％.结论 急性胆源性胰腺炎早期施行ERCP能够明确病因,疗效确切安全,能缩短住院时间及减少住院费用.
目的 探討急性膽源性胰腺炎早期內鏡治療的療效及安全性.方法 將2001年1月至2012年1月本院收治的420例急性膽源性胰腺炎按治療方式隨機分為早期(48 h內)內鏡下逆行膽胰管造影治療組(ERCP組)218例及同期保守治療組(對照組)202例.分彆觀察兩組的腹痛緩解時間、血尿澱粉酶恢複時間、肝功能恢複時間、血白細胞計數恢複時間、平均住院天數、平均費用併觀察其併髮癥髮生情況.結果 ERCP組全部成功施行內鏡下乳頭括約肌切開,172例膽總管結石患者行網籃及氣囊取石,218例均行內鏡鼻膽管引流術,重癥20例同時行胰管支架引流.ERCP組平均腹痛緩解時間及血尿澱粉酶恢複時間、肝功能恢複時間、血白細胞恢複時間、平均住院天數、平均費用均明顯低于對照組.ERCP組重癥病死率為8.0％,對照組重癥患者病死率22.2％.結論 急性膽源性胰腺炎早期施行ERCP能夠明確病因,療效確切安全,能縮短住院時間及減少住院費用.
목적 탐토급성담원성이선염조기내경치료적료효급안전성.방법 장2001년1월지2012년1월본원수치적420례급성담원성이선염안치료방식수궤분위조기(48 h내)내경하역행담이관조영치료조(ERCP조)218례급동기보수치료조(대조조)202례.분별관찰량조적복통완해시간、혈뇨정분매회복시간、간공능회복시간、혈백세포계수회복시간、평균주원천수、평균비용병관찰기병발증발생정황.결과 ERCP조전부성공시행내경하유두괄약기절개,172례담총관결석환자행망람급기낭취석,218례균행내경비담관인류술,중증20례동시행이관지가인류.ERCP조평균복통완해시간급혈뇨정분매회복시간、간공능회복시간、혈백세포회복시간、평균주원천수、평균비용균명현저우대조조.ERCP조중증병사솔위8.0％,대조조중증환자병사솔22.2％.결론 급성담원성이선염조기시행ERCP능구명학병인,료효학절안전,능축단주원시간급감소주원비용.
Objective To study the efficacy and safety of early endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy (EST) for patients with acute biliary pancreatitis.Methods 420 patients who were admitted to our hospital for management of acute biliary pancreatitis were divided into early endoscopic therapy group (n=218 patients) and conservative therapy group (n=202 patients).The durations for complete disappearance of abdominal pain,decrease in serum and urine amylase levels to normal,liver function recovery time,white blood cell recovery time,and the mean duration and costs of hospitalizations were analyzed.Results In the ERCP group,all patients received EST.The stones in 172 patients with choledocholithiasis were removed with dormia baskets or balloon catheters.In 20 patients with severe acute biliary pancreatitis,endoscopic pancreatic duct stents were inserted for drainage.The durations of complete disappearance of abdominal pain,decrease of serum and urine amylase values to normal,white blood cell recovery time,liver function recovery time,cost of hospitalization and duration of hospitalization were significantly shorter in the early ERCP group than the control group.The mortalities in the ERCP and the control groups were 8.0％ and 22.2％,respectively.Conclusions Early endoscopic management for patients with acute biliary pancreatitis was not only safe and efficacious,but the management helped to identify the underlying causes of pancreatitis and reduced the duration of hospital stay and expenses.
