十二指肠镜技术联合乌司他丁治疗急性胆源性胰腺炎的临床研究  

The clinical study of threapy with duodenoscopic technique and uliinastatin for patients with acute biliary pancreatits

作　　者：苏进根[1] 王建平[1] 陆奕宁[1] 朱堃[1] 陆惠清[1] 

机构地区：[1]上海医药高等专科学校附属嘉定区中心医院普外科,上海201800

出　　处：《肝胆外科杂志》2012年第1期55-58,共4页Journal of Hepatobiliary Surgery

基　　金：上海市嘉定区卫生局课题资金资助(项目编号20071101)

摘　　要：目的评价早期十二指肠镜技术联合乌司他丁治疗急性胆源性胰腺炎的价值及并发症。方法 150例胆源性胰腺炎患者中,72 h内行内镜治疗50例,72 h内行内镜联合乌司他丁治疗50例,保守治疗50例。比较其腹痛缓解时间,血淀粉酶及肝功能恢复时间等。结果联合组较对照组治疗后血淀粉酶恢复正常时间,肝功能恢复正常时间、腹痛缓解时间、腹部体征消失时间及体温恢复正常时间明显缩短(P=0.001或P<0.001,P<0.018)。三组血白细胞恢复正常时间无显著性差异(P=0.352)。结论早期内镜联合乌司他丁治疗对于急性胆源性胰腺炎是一种有效而安全的方法,对于有明显黄疸、感染、结石嵌顿的病例应急诊内镜治疗;对于病情较轻、黄疸不重的患者可先保守治疗后再择期内镜治疗。Objective To investigate the value and complication of therapy with duodenoscopic technique and ulinastatin of acute biliary pancreatitis （ABP）. Methods 150 cases of ABP were randomly divided into three groups, ERCP and ulinastatin treatment group （ n = 50）, ERCP treatment group （ n = 50）, non-ERCP conservative group （ n = 50）. Early endoscopic therapy was performed within 72 hours. Changes of clinical symptoms and laboratory indexes were recorded accordingly. Results The days of normalization of serum amylase, hepatic function indexes, relief of abdominal pains and signs, and the days of normalization of body temperature were significantly shorter in ERCP and ulinastatin treatment group than in ERCP treatment group and non-ERCP conservative group （P = 0. 001 or P 〈 0. 001, P 〈 0. 018 ）. Conclusions Early endoscopic and ulinastatin therapy is an effective and safe method for ABP, especially those with severe jaundice, bile duct infection and/or biliary colic. Elective ERCP/EST is indicated for patients with mild disease course and slight jaundice after conservative treatment.

关 键 词：急性胆源性胰腺炎 十二指肠镜 乌司他丁 

分 类 号：R656[医药卫生—外科学]