早期内镜治疗重症急性胆源性胰腺炎的疗效及安全性分析

Efficacy and safety of early endoscopic treatment for severe acute biliary pancreatitis

目的探讨早期内镜治疗重症急性胆源性胰腺炎的疗效及安全性。方法选择2018年1月—2019年5月本院收治的重症急性胆源性胰腺炎患者85例,按随机数字表法分为观察组(n=45)与对照组(n=40),对照组患者给予常规保守治疗,观察组患者在保守治疗基础上采取早期内镜治疗,观察比较两组治疗效果及安全性。结果观察组经早期内镜治疗手术成功率(95.56%)高于对照组(46.67%),观察组死亡率(0.00%)低于对照组(15.56%)(P<0.05);观察组治疗后血清WBC、AMY、UAMY恢复时间早于对照组(P<0.05);观察组体温恢复时间、腹痛缓解时间、腹部体征恢复时间早于对照组(P<0.05);治疗前,两组血清IL-6、IL-8、TNF-α水平比较差异无统计学意义(P>0.05),治疗后,两组血清IL-6、IL-8、TNF-α水平较治疗前降低,观察组血清IL-6、IL-8、TNF-α水平低于对照组(P<0.05);观察组术后出现脓毒血症、肾衰、急性呼吸窘迫综合征等并发症发生率(6.66%)低于对照组(27.27%)(P<0.05)。结论临床针对SABP患者给予早期内镜治疗临床疗效显著,能提高临床治疗成功率,降低死亡率,促进患者实验室指标恢复和临床症状改善,降低血清炎性因子水平,同时减少并发症的发生,安全性高,在SABP临床治疗中具有重要价值。

Objective To investigate the efficacy and safety of early endoscopic treatment for severe acute biliary pancreatitis.Methods Eighty-five patients with severe acute biliary pancreatitis admitted to our hospital from January 2018 to May 2019 were randomly divided into observation group(n=45)and control group(n=40).The patients in the control group were given conventional conservative treatment.The patients in the observation group were treated with early endoscopic treatment on the basis of conservative treatment.The therapeutic effects and safety of the two groups were observed and compared.Results The success rate of early endoscopic treatment in the observation group was higher than that in the control group(46.67%).The mortality rate in the observation group(0.00%)was lower than that in the control group(15.56%)(P<0.05).The recovery time of serum WBC,AMY and UAMY was earlier than that of the control group(P<0.05).The recovery time of body temperature,the time of relief of abdominal pain and the recovery time of abdominal signs were earlier than that of the control group(P<0.05).Before treatment,there were no statistical differences in serum IL-6,IL-8 and TNF-αlevels between the two groups(P>0.05).After treatment,the levels of serum IL-6,IL-8 and TNF-αin the two groups were lower than those before treatment.The levels of serum IL-6,IL-8 and TNF-αin the group were lower than those in the control group(P<0.05).The incidence of complications such as sepsis,renal failure and acute respiratory distress syndrome occurred in the observation group(6.66%)was lower than the control group(27.27%)(P<0.05).Conclusion The clinical efficacy of SABP patients in early endoscopic treatment is significant,which may improve the success rate of clinical treatment,reduce mortality,promote the recovery of laboratory indicators and improve clinical symptoms,reduce serum inflammatory factor levels,and reduce complications.High safety and valuable value make it effective in the clinical treatment of SABP.