EST和ENBD在急性重症胰腺炎治疗中的应用  

Treatment of severe acute pancreatitis by EST and ENBD

作　　者：张俊文[1] 高青[1] 陶小红[1] 

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆400016

出　　处：《重庆医科大学学报》2007年第7期754-755,767,共3页Journal of Chongqing Medical University

基　　金：重庆市卫生局课题(渝卫科教[2005]31号05-2-108);重庆医科大学创新基金(重医大科[2005]8号CX200504)

摘　　要：目的:探讨内镜行oddi括约肌切开术(Endoscopic Sphincterotomy,EST)和鼻胆导管引流术(Endoscopic nosalbiliary drainage,ENBD)在急性重症胰腺炎治疗中的作用。方法:77例急性重症胰腺炎患者分为内镜治疗组37例及对照组40例。内镜治疗组入院后24h内行急诊床旁EST和ENBD,对照组以内科综合治疗为主。入院后及入院后48h查血清淀粉酶,并观察入院后腹痛缓解时间。对比两组患者并发症出现的情况,住院天数。结果:内镜组入院后48h血清淀粉酶为982±24μmol/L,低于对照组1576±31μmol/L(P<0.05);内镜治疗患者腹痛缓解显效率及有效率明显高于对照组(P<0.05);并发症发生率及住院天数非常显著低于对照组(P<0.01)。结论:急诊EST和ENBD治疗重症急性胰腺炎治疗效果明显优于传统的保守治疗,行EST和ENBD时机应在发病72h内,重症胰腺炎均主张行EST和ENBD治疗。Objective ：To discuss the clinical use of endoscopic Sphincterotomy（EST）and endoscopic nosalbiliary drainage（ENBD） in the treatment of severe acute pancreatitis. Methods：77 patients were divided into the endoscopic treatment group and control group. EST plus ENBD were performed in patients of the endoscopic treatment group 24h after hospitalization. The control group were treated with the combination of treatment. Blood was drawn in each group the day and 48h following hospitalization for amylase measurement. The time of bellyache relief, the morbidity rate and hospital stay were also observed. Results：48h after hospitalization amylase measurement was significiantly lower in endoscopic treatment group 982μmol/L ±241μmol/L than that in control group（15761μmol/L±311μmol/L,P〈0.05）. The bellyache relief rate was significiantly lower in control group（P〈0. 05）;the morbidity rate and hospital stay were much significiantly lower in EST group than those in the control group（P〈0.01）. Conclusion： The excellence of EST and ENBD in the treatment group of severe acute pancreatitis is significiantly higher than that in control groups, It is recommended to perform EST and ENBD for severe acute pancreatitis of the onset of the disease which should be within72 hours.

关 键 词：内镜下oddi括约肌切开术 鼻胆导管引流术 治疗 重症急性胰腺炎 

分 类 号：R575.6[医药卫生—消化系统]