早期ERCP联合EST治疗急性胆源性胰腺炎伴急性胆管炎的临床效果  

Clinical effect of early ERCP combined with EST in the treatment of acute biliary pancreatitis with acute cholangitis

作　　者：韩肃[1] 陈西兰[1] 许明友[1] 杨先芬[1] HAN Su;CHEN Xilan;XU Mingyou;YANG Xianfen(Department of Hepatobiliary and Pancreatic Surgery,General Hospital of Anhui Wanbei Coal and Power Group,Anhui Province,Suzhou234300,China)

机构地区：[1]安徽皖北煤电集团总医院肝胆胰外科,安徽宿州234300

出　　处：《中国医药导报》2021年第22期113-116,共4页China Medical Herald

摘　　要：目的研究早期经内镜逆行胰胆管造影(ERCP)联合内镜乳头括约肌切开术(EST)治疗急性胆源性胰腺炎(ABP)伴急性胆管炎的临床效果。方法选取2018年6月至2020年6月安徽皖北煤电集团总医院肝胆胰外科接诊的90例ABP伴急性胆管炎患者作为研究对象,按照随机数表法将其分为研究组和对照组,每组45例。对照组采用保守治疗,研究组在对照组的基础上采用早期ERCP联合EST治疗。在治疗前和治疗后3 d记录两组白细胞(WBC)、血清淀粉酶(SAMY)、总胆红素(TBil)水平及各指标恢复正常时间、腹痛缓解时间、术后住院时间、治疗费用、并发症发生情况。结果治疗前,两组WBC、SAMY、TBil水平比较,差异无统计学意义(P>0.05),治疗后,两组WBC、SAMY、TBil水平均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组WBC、SAMY、TBil指标水平恢复正常时间均明显短于对照组,差异有统计学意义(P<0.05)。研究组腹痛缓解时间、术后住院时间均明显短于对照组,但治疗费用明显高于对照组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论早期ERCP联合EST治疗ABP伴急性胆管炎效果显著,可有效缩短治疗时间,但与传统的保守治疗比较,治疗费用会相对较高,可根据患者实际情况选择合适的治疗方法。Objective To study the clinical effect of early endoscopic retrograde cholangiopancreatography(ERCP)combined with endoscopic sphincterotomy(EST)in the treatment of acute biliary pancreatitis(ABP)with acute cholangitis.Methods A total of 90 patients with ABP complicated with acute cholangitis admitted to the Department of Hepatobiliary and Pancreatic Surgery,General Hospital of Anhui Wanbei Coal and Power Group,Anhui Province from June 2018 to June 2020 were selected as the research subjects.According to the random number table method,they were divided into study group and control group,with 45 patients in each group.The control group received conservative treatment,and the study group received early ERCP combined with EST on the basis of the control group.The levels of white blood cells(WBC),serum amylase(SAMY),total bilirubin(TBil),the recovery time of each index,the abdominal pain relief time,the length of postoperative hospital stay,the treatment cost and the incidence of complications were recorded before and 3 d after treatment in both groups.Results Before treatment,there were no significant differences in WBC,SAMY and TBil levels between the two groups(P>0.05).After treatment,WBC,SAMY and TBil levels in the two groups were lower than before treatment,and the study group was lower than the control group,the differences were statistically significant(P<0.05).The recovery time of the levels of WBC,SAMY and TBil indexes in the study group was significantly shorter than that in the control group,with statistical significance(P<0.05).The abdominal pain relief time and the length of postoperative hospital stay in the study group were significantly shorter than those in the control group,but the treatment cost was significantly higher than that in the control group,with statistical significance(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Early ERCP combined with EST has significant efficacy in the treatment of ABP with acute cholangi

关 键 词：急性胆源性胰腺炎 急性胆管炎 经内镜逆行胰胆管造影 内镜乳头括约肌切开术 

分 类 号：R576[医药卫生—消化系统]