内镜逆行胰胆管造影术治疗急性胆源性胰腺炎的临床疗效观察

Clinical observation of endoscopic retrograde cholangiopancreatography in treatment of acute biliary pancreatitis

目的观察内镜逆行胰胆管造影术(ERCP)治疗急性胆源性胰腺炎的效果。方法选取2016-02—2019-02间新蔡县人民医院收治的100例急性胆源性胰腺炎患者,按照随机数字表法分为2组,各50例。对照组采用药物治疗,观察组采用ERCP术治疗。比较2组治疗前后的血清炎症因子(CRP、TNF-α、IL-6、IL-8)水平、肝功能指标(AST、ALT、GGT、TBiL)、生化指标,以及临床症状改善效果。结果治疗后观察组患者的血清炎症因子水平、肝功能指标,以及体温、肝功能、淀粉酶、白细胞计数、胃肠道功能恢复正常时间,和恶心、呕吐消失及腹痛缓解时间等指标比较,均明显优于对照组,差异均有统计学意义(P<0.05)。结论采用ERCP术治疗急性胆源性胰腺炎,能有效抑制炎症因子释放,有利于改善患者的症状和促进肝功能及生化指标的恢复,是处理急性胆源性胰腺炎的重要治疗方式。

Objective To observe the clinical efficacy and therapeutic advantages of endoscopic retrograde cholangiopancreatography in the treatment of acute biliary pancreatitis.Methods Totally 100 patients with acute biliary pancreatitis admitted to our group from February 2016 to February 2019 were enrolled.According to the random number table method,50 patients were divided into the control group and the observation group respectively.Patients in the control group were treated with youtine drugs,and the observation group was treated with endoscopic retrograde cholangiopancreatography.Before and after treatment,serum inflammatory factors(CRP,TNF-α,IL-6,IL-8)levels,liver function indexes(AST,ALT,GGT,TBiL),biochemical indicators returned to normal time,and clinical symptoms were compared between the two groups.Results After treatment,serum inflammatory factors(CRP,TNF-α,IL-6,IL-8)levels in the two groups were significantly lower than those before treatment,the difference was statistically significant(P<0.05),and the serum inflammatory factors in the observation group.The levels of CRP,TNF-α,IL-6 and IL-8 were significantly lower than those of the control group(P<0.05).After treatment,liver function indexes(AST,ALT,GGT,TBiL)were significantly increased in the two groups(P<0.05).The liver function index,amylase and white blood cell counts in the observation group were significantly shorter than that of the control group(P<0.05).Intestinal ventilation time,disappearance time of nausea and vomiting,time of antipyretic and remission time of abdominal pain were significantly shorter in the observation group than that in the control group(P<0.05).Conclusion Endoscopic retrograde cholangiopancreatography for acute biliary pancreatitis can significantly improve the symptoms of patients,inhibit the release of inflammatory factors,reduce liver function damage,patients recover faster,hospitalization time is shorter,it is worthy of clinical application..