两种方法治疗67例急性重症胰腺炎的观察与护理

Observation and nursing of severe acute pancreatitis by EST and ENBD

目的探讨内窥镜行oddi括约肌切开术(endoscopic sphincterotomy,EST)和鼻胆导管引流术(endoscopic nosalbiliary drainage,ENBD)治疗急性重症胰腺炎的临床观察和护理。方法总结67例急性重症胰腺炎患者行EST和ENBD术的护理要点。结果经EST和ENBD治疗的患者腹痛缓解显效率及有效率明显高于对照组,差异有统计学意义(P<0.05);并发症发生率及住院天数低于对照组,差异有统计学意义(P<0.01)。结论EST和ENBD治疗急性重症胰腺炎的效果明显优于传统的保守治疗,术前做好充分准备、术中医护默契配合及术后精心护理是手术成功的重要因素之一。

Objective To discuss the clinical use of endoscopic sphincterotomy（EST）and endoscopic nosalbiliary drainage（ENBD） in the treatment of severe acute pancreatitis. Methods 77 patients were divided into the endo scopic treatment group and control group. EST and ENBD were performed in the patients of the endoscopic treatment group at 24 h after hospitalization. Amylase was measured in each group on the day and 48h following hospitalization. The time of bellyache relief, the morbidity and hospital stay were also observed. Results The bellyache relief rate was significantly lower in control group（P〈0.05） ; the morbidity and hospital stay were much significantly lower in EST group than those in the control group（P〈0.01）. Conclusion The excellence of EST and ENBD in the treatment group of severe acute pancreatitis is significantly higher than that in control group. It is recommended to perform EST and ENBD for severe acute pancreatitis.