现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2015年
4期
503-505
,共3页
引流术%胰腺假囊肿/治疗%内镜治疗%经内镜鼻胰管引流
引流術%胰腺假囊腫/治療%內鏡治療%經內鏡鼻胰管引流
인류술%이선가낭종/치료%내경치료%경내경비이관인류
Drainage%Pancreatic pseudocyst/therapy%Endoscopic therapies%Endoscopic naso-pancreatic drainage
目的：探讨经内镜鼻胰管引流（ENPD）治疗急性胰腺炎（AP）伴胰腺巨大假性囊肿的安全性及有效性。方法选择2010年6月至2013年6月重庆医科大学附属第一医院收治的AP伴胰腺巨大假性囊肿患者57例，分为ENPD组（29例）和对照组（28例）。ENPD组在保守治疗基础上给予ENPD治疗，对照组仅给予保守治疗。分析两组疗效及并发症发生情况。结果 ENPD组患者中因不能耐受鼻胰管分别于引流第2、5天后改用经皮穿刺引流2例。ENPD组患者腹痛缓解时间[（9.30±2.37）d]、住院时间[（26.3±5.36）d]、体温恢复正常时间[（8.59±3.27）d]、白细胞恢复正常时间（中位时间11 d）均短于对照组[分别为（14.2±2.99）、（36.8±3.59）、（13.4±3.27）d，中位时间15 d]，手术率[11.1%（3/27）]、病死率[0（0/27）]均低于对照组[分别为32.1%（9/28）、14.3%（4/28）]，差异均有统计学意义（P<0.05）。引流过程中有3例患者发生感染，但未出现胃肠道出血及穿孔等并发症，且引流完全（CT检查未见胰腺假性囊肿）。结论 ENPD能有效减轻胰管压力，控制胰腺炎进展，降低并发症发生率，治疗胰腺巨大假性囊肿更安全、有效。
目的：探討經內鏡鼻胰管引流（ENPD）治療急性胰腺炎（AP）伴胰腺巨大假性囊腫的安全性及有效性。方法選擇2010年6月至2013年6月重慶醫科大學附屬第一醫院收治的AP伴胰腺巨大假性囊腫患者57例，分為ENPD組（29例）和對照組（28例）。ENPD組在保守治療基礎上給予ENPD治療，對照組僅給予保守治療。分析兩組療效及併髮癥髮生情況。結果 ENPD組患者中因不能耐受鼻胰管分彆于引流第2、5天後改用經皮穿刺引流2例。ENPD組患者腹痛緩解時間[（9.30±2.37）d]、住院時間[（26.3±5.36）d]、體溫恢複正常時間[（8.59±3.27）d]、白細胞恢複正常時間（中位時間11 d）均短于對照組[分彆為（14.2±2.99）、（36.8±3.59）、（13.4±3.27）d，中位時間15 d]，手術率[11.1%（3/27）]、病死率[0（0/27）]均低于對照組[分彆為32.1%（9/28）、14.3%（4/28）]，差異均有統計學意義（P<0.05）。引流過程中有3例患者髮生感染，但未齣現胃腸道齣血及穿孔等併髮癥，且引流完全（CT檢查未見胰腺假性囊腫）。結論 ENPD能有效減輕胰管壓力，控製胰腺炎進展，降低併髮癥髮生率，治療胰腺巨大假性囊腫更安全、有效。
목적：탐토경내경비이관인류（ENPD）치료급성이선염（AP）반이선거대가성낭종적안전성급유효성。방법선택2010년6월지2013년6월중경의과대학부속제일의원수치적AP반이선거대가성낭종환자57례，분위ENPD조（29례）화대조조（28례）。ENPD조재보수치료기출상급여ENPD치료，대조조부급여보수치료。분석량조료효급병발증발생정황。결과 ENPD조환자중인불능내수비이관분별우인류제2、5천후개용경피천자인류2례。ENPD조환자복통완해시간[（9.30±2.37）d]、주원시간[（26.3±5.36）d]、체온회복정상시간[（8.59±3.27）d]、백세포회복정상시간（중위시간11 d）균단우대조조[분별위（14.2±2.99）、（36.8±3.59）、（13.4±3.27）d，중위시간15 d]，수술솔[11.1%（3/27）]、병사솔[0（0/27）]균저우대조조[분별위32.1%（9/28）、14.3%（4/28）]，차이균유통계학의의（P<0.05）。인류과정중유3례환자발생감염，단미출현위장도출혈급천공등병발증，차인류완전（CT검사미견이선가성낭종）。결론 ENPD능유효감경이관압력，공제이선염진전，강저병발증발생솔，치료이선거대가성낭종경안전、유효。
Objective To investigate the efficacy and safety of endoscopic naso-pancreatic drainage (ENPD) in treatment of acute pancreatitis(AP) with large pseudocyst. Methods A total of 57 AP patients with large pancreatic admitted from June 2010 to June 2013 at the First Affiliated Hospital of Chongqing Medical University were enrolled and divided into the ENPD group (29 cases)and the control group(28 cases). The patients in the control group were received conservative therapy while the ENPD group added ENPD treatment based on the conservative therapy. The cilinic effects and complications of the two groups were analyzed. Results In ENPD group,two patients failed to torlerate the ENPD to transfer to the percutaneous catheter drainage (PCD) on the 2nd and 5th days after drainage respectively. The duration of abdominal release pain ,hospitalization,normalization of body temperature and white blood cells recovery were shorter than those of the control group[ (9.30±2.37),(26.3±5.36),(8.59±3.27), vs.(14.2±2.99),(36.8±3.59),(13.4±3.27)] and the surgical operation rate and morality were lower in the ENPD group than in conservative therapy group[11.1%(3/27),0(0/27)vs. 32.1%(9/28),14.3%(4/28)],whose difference had statistical significance (P<0.05). Three patients occurred infection during ENPD course,but no perforation and bleeding occurred and drainage was complete(The pseudocyst was not found out under CT). Conclusions ENPD is avaiable to relieve the pressure of ancreatic duct, control the pancreatitis progress and reduce the occurrence of complications ,which is more effective and safe in treatment of huge pancreatic pseudocyst.
