急性胰腺炎早期ERCP、内镜治疗的应用价值及安全性  

Clinical controlled study of early ERCP and endoscopic treatment in acute pancreatitis

作　　者：李兆申[1] 许国铭[1] 孙振兴[1] 金震东[1] 邹晓平[1] 谢苏庆[1] 李平[1] 

机构地区：[1]第二军医大学长海医院消化内科

出　　处：《第二军医大学学报》1998年第5期408-410,共3页Academic Journal of Second Military Medical University

摘　　要：目的：探讨急性胰腺炎患者早期内镜逆行胰胆管造影（ＥＲＣＰ）及内镜治疗的应用价值及安全性。方法：选择６６例次急性胰腺炎患者作早期（１～７ｄ内）ＥＲＣＰ及内镜治疗（ＥＲＣＰ组），并以同期保守治疗的６０例次急性胰腺炎患者作对照（对照组），观察了两组患者血清淀粉酶恢复时间、腹痛缓解时间、住院天数及并发症发生情况。结果：（１）ＥＲＣＰ组中，３６例次为胆道疾病患者，４例次为胰管结石，４例次为胰腺分裂症，３例次为乳头旁巨大憩室，１９例次ＥＲＣＰ未见异常。（２）３３例次患者作了内镜下治疗，其中内镜下十二指肠乳头括约肌切开术及取石术１７例次，４例次作了副乳头切开及扩张术，１２例次作了鼻胆管引流术。（３）ＥＲＣＰ组腹痛缓解天数及平均住院天数分别为（１１．５±３．６）及（２１．７±５．０）ｄ，明显短于对照组（１５．４±７．８）及（３３．０±６．８）ｄ（Ｐ＜０．０１）。血清淀粉酶恢复时间两组相差不显著。两组均未发生严重并发症。结论：急性胰腺炎患者早期ＥＲＣＰ及内镜治疗是安全、有效的。Objective: To evaluate the value and safety of early endoscopic retrograde cholangiopan creatography (ERCP) and endoscopic treatment in the acute pancreatitis. Methods: One hundred and twenty six patients with acute pancreatitis were randomly divided into two groups. Sixty six patients with acute pancreatitis in the early ERCP group underwent early ERCP and endoscopic therapy (within 3-10 d). Sixty patients with acute pancreatitis were not treated by surgery, endoscope and early ERCP in the control group. The abdominal pain, serum amylase level, mean days and cost of hospitalization and complications were observed in all the patients of two groups. Results: (1) In the early ERCP group, ERCP showed biliary tract disease in 36 cases, pancreatic stones in 4, pancreatic diverticulum in 4, larger diverticula around the papilla in 3, and normal in 19. (2) Thirty three cases of biliary tract disease were treated by endoscopy including papillosphincterotomy, endoscopic nosal biliary drainage and endoscopic dilatation of the accessory papilla, with no complications. (3) There were no significant differences in the decrease of serum amylase level and the cost of hospitalization in early ERCP group and control group, but the days of the disappearance of abdominal pain and the hospitalization were significantly shorter in the early ERCP group than in the control group (P<0.01). Conclusion: It is more safe and effective that the patients with acute pancreatitis undergo early ERCP and endoscopic therapy, especially those with acute severe biliary pancreatitis.

关 键 词：胰腺炎 逆行胰胆管造影 治疗 内窥镜 

分 类 号：R576.05[医药卫生—消化系统]