胰管支架置入治疗高脂血症性胰腺炎的短期和长期疗效研究  

Pancreatic duct drainage treatment for hypertriglyceridemic pancreatitis:efficacy and recurrence rate analysis

作　　者：魏洁 赵成思 姚维杰 徐清[2] 王佐正[2] Wei Jie;Zhao Chengsi;Yao Weijie;Xu Qing;Wang Zuozheng(General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院,银川750004 [2]宁夏医科大学总医院肝胆外科,银川750004

出　　处：《中华肝胆外科杂志》2024年第9期666-671,共6页Chinese Journal of Hepatobiliary Surgery

基　　金：宁夏回族自治区高层次科技创新领军人才项目(2021GKLRLX04);宁夏回族自治区中央引导地方科技发展专项(2023FRD05009);宁夏回族自治区卫生健康系统科研课题(2023-NWKYT-021);宁夏医科大学总医院校级课题(XM2021048)。

摘　　要：目的系统性分析胰管支架置入治疗高脂血症性胰腺炎(HTGP)的短期和长期疗效。方法回顾性分析2017年1月1日至2020年6月1日在宁夏医科大学总医院接受治疗的66例HTGP患者,其中男性53例,女性13例,年龄(39.67±9.99)岁。根据是否接受胰管支架置入治疗,患者被分为支架组(20例)和保守组(46例),比较两组患者症状缓解、生化指标恢复、复发率及并发症发生率等短期和长期疗效指标。结果在短期疗效方面与保守组比较,支架组患者的急性生理与慢性健康评分[(2.85±1.66)分比(4.59±2.60)分,P=0.008]、器官功能衰竭发生率[15.0%(3/20)比41.3%(19/46),P=0.037]和短期并发症发生率[10.0%(2/20)比60.9%(28/46),P=0.012]均低于保守组,差异具有统计学意义。在长期疗效方面,支架组与保守组的中位首次复发时间分别为15个月和12个月,差异有统计学意义(Z=2.04,P=0.042);但两组患者的复发率差异无统计学意义[50.0%(9/18)比57.9%(22/38),P=0.579];支架组的后期并发症发生率低于保守组[5.6%(1/18)比31.6%(12/38),P=0.042],差异具有统计学意义。结论胰管支架置入治疗在改善HTGP患者的短期症状和降低并发症发生率方面具有显著优势,但整体复发率未显著降低。ObjectiveTo systematically analyze the short-term and long-term efficacy of pancreatic stent placement in the treatment of hyperlipidemic pancreatitis(HTGP).MethodsThis retrospective case-control study included 66 HTGP patients who received treatment at the General Hospital of Ningxia Medical University from January 1,2017 to June 1,2020.Among them,53 were male and 13 were female,with an age of(39.67±9.99)years.Patients were divided into stent group(20 cases)and conservative group(46 cases)based on whether they received pancreatic stent placement treatment.The main observation indicators included symptom relief,biochemical index recovery,recurrence rate,and incidence of complications.ResultsIn terms of short-term efficacy,compared with the conservative group,the stent group showed significantly better acute physiology and chronic health evaluation II scores[(2.85±1.66)vs.(4.59±2.60),P=0.008],lower incidence of organ failure[15.0%(3/20)vs.41.3%(19/46),P=0.037],and lower incidence of short-term complications[10.0%(2/20)vs.60.9%(28/46),P=0.012],all of which were statistically significant.In terms of long-term efficacy,the median time to first recurrence was significantly longer in the stent group(15 months)compared to the conservative group(12 months)(Z=2.04,P=0.042).However,there was no statistically significant difference in recurrence rates between the two groups[50.0%(9/18)vs.57.9%(22/38),P=0.579].The incidence of late complications was also significantly lower in the stent group[5.6%(1/18)vs.31.6%(12/38),P=0.042].ConclusionsPancreatic stent placement therapy has significant advantages in improving short-term symptoms and reducing the incidence of complications in HTGP patients,but the overall recurrence rate do not significantly decrease.

关 键 词：胰腺炎 高三酰甘油血症 胰管支架 疗效 

分 类 号：R589.2[医药卫生—内分泌] R576[医药卫生—内科学]