内镜技术治疗慢性胰腺炎的临床应用价值  

Evaluation of endoscopic treatment for chronic pancreatitis

作　　者：麻树人[1] 张宁[1] 赵志峰[1] 潘汝明[1] 杨琳[1] 宫照杰[1] 袁爱娇[1] 张新生[1] 

机构地区：[1]沈阳军区总医院沈阳军区消化内镜中心,沈阳110016

出　　处：《解放军医学杂志》2005年第9期831-832,共2页Medical Journal of Chinese People's Liberation Army

基　　金：辽宁省科学技术计划立项课题(编号2003225007-10)

摘　　要：目的探讨内镜在慢性胰腺炎治疗中的临床应用价值。方法回顾性分析2002～2004年内镜治疗慢性胰腺炎患者33例的临床疗效。所有慢性胰腺炎病例均经临床检查、实验室检查、CT、超声及ERCP确诊。根据患者的情况采取单独或联合进行经内镜胰管括约肌切开(EPS)、乳头括约肌切开(EST)、胰管内支架(PS)、胰石取出、鼻胰引流(ENPD)、胰管狭窄扩张等治疗措施。结果18例行EPS,27例行EST,6例行网篮或气囊取胰石,13例行PS,5例行ENPD,9例行胰管扩张,1例巨大假性囊肿经胃壁穿刺放置内支架引流。33例中29例治疗后腹痛消失或明显减轻。治疗后复查实验室检查及影像指标均有明显改善。结论内镜技术联合应用治疗慢性胰腺炎是一种较安全、低创伤、有效的方法。Objective To evaluate the effects of endoscopic treatment on chronic pancreatitis. Methods 33 cases with chronic pancreatiffs having received endoscopic treatment in a 2 years＇ period were retrospectively analyzed. The diagnosis was confirmed in all the patients by clinical examination, lab tests, CT, uhrasonography and endoscopic retrograde cholangiopancreatography （ERCP）. According to the patients＇ condition, various treatment measures including endoscopic pancreatic sphincterotomy （EPS）, endoscopic papillo-sphincterotomy （EST）, pancreatic stenting （PS）, pancreatic stone extraction, naso-pancreatic drainage （ENPD）, pancreatic duct stricture dilation, etc, were used individually or jointly. Results 18 cases received EPS and 27 underwent EST. Pancreatic duct stone extraction by basket or balloon was performed in 6 cases, PS in 13, ENPD in 5, and pancreatic duct dilatation in 9 cases. The endoscopic drainage by transgastric placement of a stent was done in a patient with a huge pseudocyst. Abdominal pain disappeared or markedly relieved in 29 cases after treatment. Marked improvement after treatment was shown by lab examination and imaging. Conclusion The combined application of various treatment measures for chronic pancreatitis through endoscopic approach is a safe, minimal-invasive and effective procedure.

关 键 词：胰腺炎 慢性 内窥镜检查 消化系统 

分 类 号：R576.2[医药卫生—消化系统]