内镜下括约肌切开取石联合鼻胆管引流术治疗急性胆源性胰腺炎患者的效果  

Effect of Endoscopic Sphincterotomy Combined with Nasobiliary Drainage in the Treatment of Patients with Acute Biliary Pancreatitis

作　　者：胡恒 汪洋 HU Heng;WANG Yang(Jingzhou Third People's Hospital,Jingzhou 434001,China;不详)

机构地区：[1]荆州市第三人民医院,湖北荆州434001 [2]湖北省妇幼保健院

出　　处：《中外医学研究》2025年第5期32-35,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:评估内镜下括约肌切开取石联合鼻胆管引流术治疗急性胆源性胰腺炎患者的效果。方法:选取2021年10月—2022年10月荆州市第三人民医院收治的72例急性胆源性胰腺炎患者为研究对象,根据随机数表法将患者分为两组,各36例。对照组采用腹腔镜胆总管切开联合胆道镜探查术治疗,观察组取内镜下括约肌切开取石联合鼻胆管引流术治疗。对比两组手术前后生化指标、急性胰腺炎评分、急性生理与慢性健康评分、时间指标、术后并发症情况。结果:手术后,观察组白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α、血淀粉酶低于对照组,差异有统计学意义(P<0.05)。手术后3 d、7 d,观察组急性胰腺炎评分、急性生理与慢性健康评分低于对照组,差异有统计学意义(P<0.05)。观察组体温恢复时间、腹痛缓解时间、排气时间、引流时间、住院时间均优于对照组,差异有统计学意义(P<0.05)。观察组术后腹痛、腹胀、出血、胆道感染等并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:急性胆源性胰腺炎患者行内镜下括约肌切开取石联合鼻胆管引流术治疗的效果显著,可减轻炎症反应,改善急性胰腺炎评分、急性生理与慢性健康评分,缩短住院时间,降低并发症发生率。Objective:To evaluate the effect of endoscopic sphincterotomy combined with nasobiliary drainage in the treatment of patients with acute biliary pancreatitis.Method:A total of 72 patients with acute biliary pancreatitis diagnosed in Jingzhou Third People's Hospital from October 2021 to October 2022 were selected and randomly divided into two groups,each with 36 cases.The control group was treated with combination of laparoscopic common bile duct incision and choledochoscopy exploration,while the observation group was treated with combination of endoscopic sphincterotomy and nasobiliary drainage.Biochemical indicators,acute pancreatitis score,acute physiological and chronic health score before and after operation,time indicators and postoperative complications were compared between the groups.Result:After operation,interleukin-6,interleukin-8,tumor necrosis factor-αand blood amylase in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).At 3 d and 7 d after operation,the acute pancreatitis scores,acute physiological and chronic health scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The temperature recovery time,abdominal pain relief time,exhaust time,drainage time and hospitalization time in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications such as abdominal pain,abdominal distension,hemorrhage and biliary tract infection in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:In patients with acute biliary pancreatitis,endoscopic sphincterotomy combined with nasobiliary drainage can significantly reduce inflammatory response,improve acute pancreatitis scores,acute physiological and chronic health scores,shorten hospital stay,and reduce the incidence of complications.

关 键 词：急性胆源性胰腺炎 内镜下括约肌切开取石术 鼻胆管引流术 术后并发症 

分 类 号：R65[医药卫生—外科学]