EUS联合ERCP在梗阻型轻症急性胆源性胰腺炎中应用及对细胞因子和淀粉酶的影响

The effects of EUS combined with ERCP on obstructive mild acute gallstone pancreatitis and the influences on cytokines and amylase

目的观察超声内镜(EUS)联合十二指肠镜逆行性胆胰管造影(ERCP)对梗阻型轻症急性胆源性胰腺炎患者的治疗效果及对细胞因子、淀粉酶的影响。方法梗阻型轻症急性胆源性胰腺炎患者90例,随机分为对照组(n=45)和观察组(n=45)。对照组采用开腹手术治疗,观察组采用EUS联合ERCP治疗。观察两组治疗前、后肿瘤坏死因子(TNF)-α、白细胞介素(IL)-2、白细胞IL-6、IL-8、IL-10及淀粉酶水平变化。结果观察组治疗后腹痛缓解时间、尿淀粉酶恢复正常时间、血淀粉酶恢复正常时间及住院时间、显著短于对照组(P<0.05);观察组治疗后TNF-α、IL-2、IL-6及IL-8水平低于对照组(P<0.05);观察组术后并发症发生率(8.89%),显著低于对照组(20.00%,P<0.05)。结论梗阻型轻症急性胆源性胰腺炎患者采用EUS联合ERCP治疗效果理想。

Objective To observe the effects of endoscopic ultrasound （EUS） joint duodenoscopy retrograde cholangiopancreatography （ERCP） on the treatment of obstructive mild acute gallstone pancreatitis and the influences on cytokines and amylase. Methods 90 cases of mild obstructive acute gallstone pancreatitis were randomly divided into control and observation groups. The observation group was given EUS combined with ERCP treatment. The levels of tumor necrosis factor（TNF）-α, interleukin（IL）-2, IL-6, IL-8 and IL-10 were analyzed. Results Mter treatment, abdominal pain time, urine amylase returned to normal, serum amylase recovery time and hospital stay of observation group were significantly shorter than those of control group（P〈0. 05） ; the levels of TNF-α, IL-2, IL-6 and IL-8 were higher than those of control group（P〈0.05） ; postoperative complications occurred in the observation group was 8.89%, which was significantly lower than that of control group 20.00% （P〈0.05）. Conclusions Mild obstruction patients with acute gallstone pancreatitis over EUS combined with ERCP treatment should be widely applied.