内镜联合腹腔灌洗治疗早期急性重症胆源性胰腺炎  

Endoscopy combined with peritoneal lavage for the treatment of severe acute bili ogenic pancreatitis

作　　者：李玉民[1] 李汛[1] 周文策[1] 石斌[1] 李世雄[1] 何登瀛[1] 曹农[1] 芦国芳[1] 李琼[1] 

机构地区：[1]兰州医学院第一附属医院普外科,730000

出　　处：《中华普通外科杂志》2001年第11期650-652,共3页Chinese Journal of General Surgery

摘　　要：目的　探讨内镜联合腹腔穿刺灌洗治疗早期重症胆源性胰腺炎的效果。方法　将急性重症胆源性胰腺炎患者 62例随机分为 2组 ,即内镜联合腹腔灌洗组 (简称内镜组 ) 3 2例和保守治疗组 (对照组 ) 3 0例。内镜组在入院 3d内行内镜胰胆管造影加内镜乳头括约肌切开 ,并在B超引导下行腹腔穿刺引流 ,用生理盐水和甲硝唑灌洗腹腔 ,其他治疗同对照组。分别观察 2组患者的腹痛缓解时间、血、尿淀粉酶及WBC恢复至正常范围的时间、平均住院时间、1个月内手术率、并发症发生率、病死率以及治愈率。结果　内镜组比对照组各项观察指标值均明显降低 ,P值均 <0 0 5。结论内镜联合腹腔灌洗治疗早期重症胆源性胰腺炎安全有效、创伤小、恢复快、并发症少 ,可在一定程度上替代外科手术治疗。Objective To evaluate endos copy combined with peritoneal lavage for the treatment of severe acute biliogen ic pancreatitis(SAP).Methods 62 cas es of SAP were randomized into endoscopic intervention group (32 cases) and con trol group (30 cases) treated conservatively. The endoscopic group were treated with ERCP and EST,and BUS guided abdominal paracentesis drainage and antibiotic lavage. Abdomi nal pain, amylase level in blood and urine, WBC counts, average hospital stay, t he operation rate within one month, complication, mortality and curative rate in patients of the two groups were recorded and compared.Results Results in endoscopic group were superior to contro l group (all P<0.05) in all above-mentioned parameters.ConclusionSafe, effective, less trauma tic, quick r ecovey is characteristic of the combined therapy consisted of endoscopy, periton eal lavage for the treatment of severe acute biliogenic pancreatitis.

关 键 词：括约肌切开术 内窥镜 重症急性胰腺炎 腹腔灌洗 胆源性胰腺炎 

分 类 号：R657.51[医药卫生—外科学]