内镜治疗急诊高龄急性重症胆源性胰腺炎80例分析

Analysis on emergency ERCP treatment of 80 cases of elderly patients with severe acute biliary pancreatitis

目的通过观察急诊内镜(ERCP)治疗前后急性重症胆源性胰腺炎(ABP)患者血清TNF-α、IL-6、IL-8水平变化,进一步确立ERCP在治疗ABP的临床意义。方法本实验通过随机、对照、前瞻的研究,把80例高龄ABP患者随机分成两组,其中内镜组37例,常规内科综合治疗,并在发病12～48 h内行急诊治疗性ERCP,对照组43例行常规内科综合治疗。结果两组治疗前、后血清TNF-α、IL-6、IL-8比较,差异有统计学意义(P<0.05)。内镜组腹痛缓解时间、住院时间和对照组比较差异有统计学意义(P<0.05)。结论早期ERCP治疗重症ABP是安全有效的方法,特别是对高龄患者,能迅速缓解ABP的病情,有效缩短患者腹痛缓解时间以及住院时间。

Objective To observe the serum TNF-α,IL-6,IL-8 levels in patients with severe acute biliary pancreatitis（ABP） before and after emergency ERCP treatment,further establishing the clinical significance of ERCP in the treatment of ABP. Methods In this study,through the randomized,controlled,prospective research,80 elderly patients with ABP were randomly divided into 2 groups： ERCP group（n=37） were treated with routine comprehensive medical treatment and emergency treatment of ERCP were performed within 12~48h after onset;control group（n=43） were treated with routine medical comprehensive treatment. Results The serum TNF-α,IL-6,IL-8 in two groups before and after treatment had statistic difference（P 0.05）.The difference of abdominal pain relief time and hospitalization time between ERCP group and control group had statistical significance（P0.05）. Conclusion Early ERCP treatment for severe ABP is a safe and effective method,especially in elderly patients,can quickly ease the condition to the ABP patients,shorten the time of abdominal pain and hospital stay.