急性胆源性胰腺炎ERCP手术治疗前后对患者肝功能及炎症因子的影响

Effects of ERCP for acute biliary pancreatitis on liver function and inflammatory factors

目的观察急性胆源性胰腺炎(ABP)内镜逆行胰胆管造影(ERCP)手术治疗对患者肝功能、炎症因子的影响。方法选取2016年2月~2018年3月我院85例ABP患者,依据治疗方式差异分为观察组(n=45)与对照组(n=40),对照组予以常规非手术疗法,观察组于其基础上采取ERCP手术。比较两组治疗前后肝功能[谷丙转氨酶(ALT)、总胆红素(TBil)、γ谷氨酰转肽酶(γ-GT)]、炎症因子[白细胞计数(WBC)、C反应蛋白(CRP)],观察两组腹痛消失时间、淀粉酶恢复时间、住院时间及并发症发生率。结果治疗后,两组ALT、TBil、γ-GT、WBC、CRP水平较治疗前明显降低(P<0.05),且观察组ALT、TBil、γ-GT、WBC、CRP水平明显低于对照组(P<0.05);观察组腹痛消失时间、淀粉酶恢复时间、住院时间均明显短于对照组(P<0.05);观察组并发症总发生率明显低于对照组(P<0.05)。结论ERCP治疗ABP患者后肝功能恢复较快,可有效减轻炎症状态,促进机体恢复。

Objective To observe effects of endoscopic retrograde cholangiopancreatography(ERCP)on liver function and inflammatory factors in patients with acute biliary pancreatitis(ABP).Methods 85 ABP patients in the hospital were enrolled.According to different treatment methods,they were divided into observation group(n=45)and control group(n=40).The control group was given routine non-surgical treatment.On this basis,the observation group was given ERCP.Liver function(alanine aminotransferase(ALT),total bilirubin(TBil),γglutamyl transpeptidase(γ-GT)and inflammatory factors(white blood cell count(WBC),C-reactive protein(CRP)))before and after treatment were compared between the two groups.The disappearance time of abdominal pain,amylase recovery time,hospitalization time and incidence of complications in both groups were observed.Results After treatment,levels of ALT,TBil,γ-GT,WBC and CRP in both groups were significantly decreased(P<0.05).And the above indexes in observation group were significantly lower than those in control group(P<0.05).The disappearance time of abdominal pain,amylase recovery time and hospitalization time in observation group were significantly shorter than those in control group(P<0.05).The total incidence of complications in observation group was significantly lower than that in control group(6.67%vs 25.00%)(P<0.05).Conclusion The postoperative recovery of liver function is rapid with ERCP in treatment of ABP,which can effectively reduce inflammatory status,promote recovery of signs,with few complications.