治疗性ERCP在急性胆源性胰腺炎的临床疗效分析

Clinical Analysis of Therapeutic Endoscopic Retrograde Cholangiopancreatography in Acute Biliary Pancreatitis

目的对发病早期(72h)患有急性胆源性胰腺炎的病人行ERCP(内镜逆行胰胆管造影)、EST(内镜下括约肌切开术)、ENBD(内镜下鼻胆管引流术)等诊断及微创治疗,以动态评价治疗性ERCP的安全性和临床疗效。方法随机将100例急性胆源性胰腺炎患者分为A、B两组,A组行ERCP检查和治疗,B组行内科保守疗,分别观察两组的腹痛缓解时间、胰腺炎相关的并发症的发生率、病死率及住院时间,及治疗后前3d的血淀粉酶、白细胞数、体温的动态变化。结果患者A组较B组在48h、72h血淀粉酶、白细胞数、体温的动态变化显著,两组的腹痛缓解时间、胰腺炎相关的并发症的发生率及住院时间差异显著。结论在早期急性胆源性胰腺炎的临床中,治疗性ERCP是安全、有效的方法。

Objective To evaluate the clinical efficacy and safety of therapeutic endoscopic retrograde cholangiopancreatography （ERCP） including endoscopic sphincterotomy（EST） and endoscopic nasal biliary drainage（ENBD） in early acute biliary pancreatitis（72 h）. Methods 100 cases of acute biliary pancreatitis, which were randomly divided into A and B groups, were respectively treated with early therapeutic ERCP and internal medical therapy with effect, complications and safety evaluated. Results The level sof serum amylase, leukocyte, body temperature, related severe complications were obviously different from group A to group B （P 〈0.05）. Significant differences of medium abdominal pain-relieving time and medium hospitalization time existed between two groups. Conclusion The results indicate that therapeutic endoscopic retrograde cholangiopancreatography is an effective, safe treatment for acute biliary pancreatitis.