十二指肠乳头括约肌切开术在不明原因复发性胰腺炎治疗中的应用

Application of duodenal papillary sphincterotomy in the treatment of recurrent pancreatitis with unknown reasons

目的探析不明原因复发性胰腺炎应用十二指肠乳头括约肌切开术治疗的临床效果。方法选择2013年4月~2016年1月本院收治的不明原因复发性胰腺炎患者60例,根据随机数字表法分为对照组和观察组,每组30例。观察组进行十二指肠乳头括约肌切开术和内镜逆行胰胆管造影术,对照组进行保守疗法治疗,比较两组的临床效果、治疗后的住院时间、血淀粉酶恢复正常时间、血糖恢复正常时间、腹胀消失时间、腹痛消失时间、肌紧张消失时间等临床指标;比较两组治疗后的并发症发生情况。结果观察组的临床有效率为93.3%,对照组的临床有效率为60.0%,两组比较差异有统计学意义(P<0.05);两组治疗后的血淀粉酶恢复正常时间、血糖恢复正常时间、腹胀消失时间、腹痛消失时间、肌紧张消失时间等临床指标均有改善,但观察组治疗后的住院时间、血淀粉酶恢复正常时间、血糖恢复正常时间、腹胀消失时间、腹痛消失时间、肌紧张消失时间等临床指标显著优于对照组,差异有统计学意义(P<0.05);观察组治疗后出现弥漫性腹腔感染、复发、疼痛等并发症情况显著低于对照组,差异有统计学意义(P<0.05)。结论不明原因复发性胰腺炎患者进行十二指肠乳头括约肌切开术疗法,可显著改善患者的临床症状,降低治疗后并发症的发生率,临床效果确切,值得临床推广。

Objective To investigate the clinical effect of duodenal papillary sphincterotomy in the treatment of recurrent pancreatitis with unknown reasons.Methods A total of 60 patients with recurrent pancreatitis with unknown reasons who were admitted to our hospital from April 2013 to January 2016 were selected in this study.According to the random number table method,the patients were divided into the control group and the observation group,with 30 cases in each group.The observation group was treated with duodenal papillary sphincterotomy and endoscopic retrograde cholangiopancreatography,and the control group was given conservative therapy.The clinical effects of the two groups were compared.The time of hospitalization after treatment,the time of blood amylase resuming to normal,the time of blood glucose resuming to normal,the time of disappearance of abdominal distension,the time of disappearance of abdominal pain,and the time of disappearance of muscle tension were compared between the two groups;the incidence of complications after treatment was compared between the two groups.Results The clinical effective rate was 93.3%in the observation group and 60.0%in the control group.There was statistically significant difference between the two groups（P〈0.05）;after the treatment,the time of blood amylase resuming to normal,the time of blood glucose resuming to normal,abdomen distension disappearing time,abdominal pain disappearing time,muscle tension disappearing time and other clinical indicators were all improved in both groups.However,the length of stay,the time of blood amylase resuming to normal,the time of blood glucose resuming to normal,abdomen distension disappearing time,abdominal pain disappearing time,muscle tension disappearing time and other clinical indicators in the observation group after the treatment were significantly better than those in the control group,and the differences were statistically significant（P〈0.05）;the complications of diffuse abdominal infection,recurrence and pain were significantly lower in the observation group than those in the control group after the treatment,and the differences were statistically significant（P〈0.05）.Conclusion The treatment of duodenal papillary sphincterotomy in the patients with recurrent pancreatitis with unknown reasons can significantly improve patients＇ clinical symptoms and reduce the incidence of complications after the treatment.The clinical results are accurate,which is worthy of clinical promotion.