CAJ | 학술논문

目的观察内镜治疗急性胆源性胰腺炎(ABP)的疗效及其并发症.方法急性胆源性胰腺炎70例,其中37例于24 h内行逆行胰胆管造影术(ERCP)、内镜下乳头括约肌切开(EST)后用网篮取石或碎石网篮碎石后气囊取石术及内镜下鼻胆管引流术(内镜组);另33例行保守或急诊外科手术治疗(对照组).结果内镜组治疗的成功率为92%,未发生与内镜操作有关的严重并发症;与对照组比较,内镜组术后腹痛缓解时间、住院时间明显缩短(P<0.01),术后第1天血及尿淀粉酶无明显差异(P>0.05),但术后第2天血及尿淀粉酶明显降低(P<0.05),第3天降低更为明显(P<0.01).结论急性胆源性胰腺炎早期ERCP及内镜治疗安全有效,是治疗急性胆源性胰腺炎的理想方法.
목적 관찰내경치료급성담원성이선염(ABP)적료효급기병발증.방법 급성담원성이선염70례,기중37례우24 h내행역행이담관조영술(ERCP)、내경하유두괄약기절개(EST)후용망람취석혹쇄석망람쇄석후기낭취석술급내경하비담관인류술(내경조);령33례행보수혹급진외과수술치료(대조조).결과 내경조치료적성공솔위92%,미발생여내경조작유관적엄중병발증;여대조조비교,내경조술후복통완해시간、주원시간명현축단(P<0.01),술후제1천혈급뇨정분매무명현차이(P>0.05),단술후제2천혈급뇨정분매명현강저(P<0.05),제3천강저경위명현(P<0.01).결론 급성담원성이선염조기ERCP급내경치료안전유효,시치료급성담원성이선염적이상방법.
Objective To observe the therapeutic effects and complication of combined endoscopic trerapy of the acute biliary pancreatitis(ABP). Methods 70 cases of acute biliary pancreatitis were treated in our hospital in recent 7 years.37 cases(group E) admitted undergone emergency endoscope procedure were treated with endoscopi- cretrograde cholongiopancreatography ( ERCP ), endpscopic sphincterotomy ( EST ) and endoscope naso-biliary drainage(ENBD) in 24h after be hospitalized. 33 cases(group C) were treated with conservation treatment or opera-tion treatment. Results Achievement ratio of endoscopic management was 92 %. There was no severe complication or mortality in group E. The duration of symptoms and hospitalization in endoscopy group were significantly shorter than those in group C(P<0.01). The change of serum and urine amylase was not significant between two groups in the first day after treatment(P > 0.05). But the serum and urine amylase of group E were significantly lower than those in group C in the second day(P< 0.05) and more significantly lower in the third day after treatment(P< 0.01 ). Conclusion Early endoscopic therapy is safe and effective in ABP patients. It is a valuable method to treat a- cute biliary pancreatitis.