ERCP治疗急性胆源性胰腺炎疗效及其术后并发症的影响因素分析  

Analysis of the effect of ERCP on acute biliary pancreatitis and the influencing factors of postoperative complications

作　　者：沈凤[1] 王保健[1] 顾文芬[1] Shen Feng;Wang Bajian;Gu Wenfen(Sichuan Pangang Group General Hospital(Panzhihua 617023))

机构地区：[1]四川省攀钢集团总医院,攀枝花617023

出　　处：《陕西医学杂志》2018年第8期984-986,993,共4页Shaanxi Medical Journal

摘　　要：目的:探讨经内镜逆行胰胆管造影(ERCP)检查及治疗对急性胆源性胰腺炎的临床效果及影响术后并发症发生的相关因素。方法:选择80例急性胆源性胰腺炎患者分为40例ERCP组和40例对照组,ERCP组采用经ERCP检查行内镜下十二指肠乳头括约肌切开(EST)、内镜下鼻胆管引流(ENBD)治疗;对照组采用保守治疗法,对比两组疗效(淀粉酶恢复时间、症状缓解时间、住院天数)和术后并发症情况,并对影响术后并发症发生的相关因素进行多元线性回归分析。结果:经治疗,在淀粉酶恢复时间、症状缓解时间、住院天数等3个疗效指标上观察组用时均显著低于对照组,组间比较显示差异有统计学意义(P<0.05);观察组并发症发生率(12.82%)显著低于对照组(38.46%),组间比较显示差异有统计学意义(P<0.05);Logitic分析显示,球囊扩张、合并症、急性胆源性胰腺炎病史、导丝多次进入胰管为影响术后并发症发生相关因素。结论:相较于保守治疗,对急性胆源性胰腺炎患者实行ERCP检查下EST及ENBD治疗疗效更好,显著改善患者临床症状,缩短住院时间及淀粉酶恢复时间,有效降低术后并发症发生,同时球囊扩张、合并症、急性胆源性胰腺炎病史、导丝多次进入胰管是影响术后并发症发生的主要风险因素。Objective:To investigate the clinical effect of endoscopic retrograde cholangiopancreatography(ERCP)examination and treatment on acute biliary pancreatitis and the related factors that influence postoperative complications.Methods:We selected 80 cases of acute biliary pancreatitis patients,and divided into two groups ERCP group and control group,40 cases each group,ERCP group was examined by ERCP underwent endoscopic sphincterotomy(EST)and endoscopic nasobiliary drainage(ENBD)treatment;the control group was treated with conservative therapy,compared two groups the curative effect(amylase recovery time,symptoms time,hospitalization time and postoperative complications),multiple linear regression analysis and related factors affect the occurrence of postoperative complications.Results:After treatment,recovery time,symptoms remission time,hospitalization days 3 indicators of efficacy observation group was significantly lower than the control group,comparison between groups showed there was statistically significant difference between two groups(P<0.05);the complication rate of the observation group(12.82%)was significantly lower than the control group(38.46%),there was statistically significant difference between two groups(P<0.05);Logitic analysis showed that the balloon dilation,complications,disease,guidewire enters the pancreatic duct several times was related factors of affecting postoperative complications.Conclusion:The curative effect in the treatment of EST and ENBD under ERCP examination for the patients with acute biliary pancreatitis is better than Conservative treatment,Significantly improve the patient's clinical symptoms,shorten the time of hospitalization and amylase recovery,Effectively reduce postoperative complications,at the same time,balloon dilatation,complications,disease,acute biliary pancreatitis guide wire several times into the pancreatic duct is the primary risk factors for affecting postoperative complications.

关 键 词：胰腺炎/治疗 胰胆管造影术 内窥镜逆行/方法 并发症 影响因素 

分 类 号：R576[医药卫生—消化系统]