内镜下鼻胰管引流治疗胰腺巨大假性囊肿疗效分析  

Efficacy of endoscopic naso-pancreatic drainage in treatment of huge pancreatic pseudocyst

作　　者：张静[1] 刘宏[2] 谢友红[1] 

机构地区：[1]重庆医科大学附属大学城医院,重庆401331 [2]重庆医科大学附属第一医院,重庆400016

出　　处：《现代医药卫生》2015年第4期503-505,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨经内镜鼻胰管引流(ENPD)治疗急性胰腺炎(AP)伴胰腺巨大假性囊肿的安全性及有效性。方法选择2010年6月至2013年6月重庆医科大学附属第一医院收治的AP伴胰腺巨大假性囊肿患者57例,分为ENPD组(29例)和对照组(28例)。ENPD组在保守治疗基础上给予ENPD治疗,对照组仅给予保守治疗。分析两组疗效及并发症发生情况。结果 ENPD组患者中因不能耐受鼻胰管分别于引流第2、5天后改用经皮穿刺引流2例。ENPD组患者腹痛缓解时间[(9.30±2.37)d]、住院时间[(26.3±5.36)d]、体温恢复正常时间[(8.59±3.27)d]、白细胞恢复正常时间(中位时间11 d)均短于对照组[分别为(14.2±2.99)、(36.8±3.59)、(13.4±3.27)d,中位时间15 d],手术率[11.1%(3/27)]、病死率[0(0/27)]均低于对照组[分别为32.1%(9/28)、14.3%(4/28)],差异均有统计学意义(P<0.05)。引流过程中有3例患者发生感染,但未出现胃肠道出血及穿孔等并发症,且引流完全(CT检查未见胰腺假性囊肿)。结论 ENPD能有效减轻胰管压力,控制胰腺炎进展,降低并发症发生率,治疗胰腺巨大假性囊肿更安全、有效。Objective To investigate the efficacy and safety of endoscopic naso-pancreatic drainage（ENPD） in treatment of acute pancreatitis（AP） with large pseudocyst. Methods A total of 57 AP patients with large pancreatic admitted from June2010 to June 2013 at the First Affiliated Hospital of Chongqing Medical University were enrolled and divided into the ENPD group（29 cases）and the control group（28 cases）. The patients in the control group were received conservative therapy while the ENPD group added ENPD treatment based on the conservative therapy. The cilinic effects and complications of the two groups were analyzed.Results In ENPD group,two patients failed to torlerate the ENPD to transfer to the percutaneous catheter drainage（PCD） on the2 nd and 5th days after drainage respectively. The duration of abdominal release pain,hospitalization,normalization of body temperature and white blood cells recovery were shorter than those of the control group[（9.30±2.37）,（26.3±5.36）,（8.59±3.27）,vs.（14.2 ±2.99）,（36.8 ±3.59）,（13.4 ±3.27）] and the surgical operation rate and morality were lower in the ENPD group than in conservative therapy group [11.1%（3/27）,0（0/27）vs. 32.1%（9/28）,14.3%（4/28）],whose difference had statistical significance（P〈0.05）. Three patients occurred infection during ENPD course,but no perforation and bleeding occurred and drainage was complete（The pseudocyst was not found out under CT）. Conclusions ENPD is avaiable to relieve the pressure of ancreatic duct,control the pancreatitis progress and reduce the occurrence of complications,which is more effective and safe in treatment of huge pancreatic pseudocyst.

关 键 词：引流术 胰腺假囊肿/治疗 内镜治疗 经内镜鼻胰管引流 

分 类 号：R657.510.5[医药卫生—外科学]