内镜逆行胰胆管造影联合内镜乳头括约肌切开术对急性胆源性胰腺炎患者的效果分析

Clinical Analysis of Endoscopic Retrograde Cholangiopancreatography Combined with Endoscopic Sphincterotomy in Patients with Acute Biliary Pancreatitis

目的:探究内镜逆行胰胆管造影(ERCP)联合内镜乳头括约肌切开术(EST)对急性胆源性胰腺炎(ABP)患者的治疗效果。方法:选取2016年12月—2021年12月福建医科大学附属龙岩第一医院肝胆外科收治的80例ABP患者为研究对象,以随机数表法对患者进行分组,对照组(40例)行保守治疗,观察组(40例)在对照组基础上行ERCP+EST。比较两组炎症因子、肝功能、恢复情况及并发症情况。结果:观察组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞(WBC)计数、D-二聚体(D-D)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转移酶(GGT)、总胆红素(TBIL)、血淀粉酶(AMY)均低于对照组,差异有统计学意义(P<0.05)。观察组AMY恢复时间、WBC恢复时间、TBIL恢复时间较对照组早,术后并发症总发生率较对照组低,差异有统计学意义(P<0.05)。结论:ABP患者给予ERCP+EST联合治疗后,可有效缓解炎症反应,并且对肝功能的影响较小,并发症发生率也较低,提示该疗法可以促进患者的病情恢复,具有显著的治疗效果。

Objective:To investigate the effect of endoscopic retrograde cholangiopancreatography(ERCP)combined with endoscopic sphincterotomy(EST)in the treatment of patients with acute biliary pancreatitis(ABP).Method:A total of 80 patients with ABP admitted to the Department of Hepatobiliary Surgery,Longyan First Hospital Affiliated to Fujian Medical University from December 2016 to December 2021 were selected as the research objects,they were divided into groups by random number table,the control group(40 cases)received conservative treatment,and the observation group(40 cases)received ERCP+EST on the basis of the control group.Inflammatory factors,liver function,recovery and complications were compared between the two groups.Result:C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),white blood cell(WBC)count,D-dimer(D-D),alanine aminotransferase(ALT),glutamyl aminotransferase(AST),glutamyl transpeptide(GGT),total bilirubin(TBIL)and blood amylase(AMY)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The recovery time of AMY,WBC and TBIL in the observation group were earlier than those in the control group,and the total incidence of postoperative complications was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:In ABP patients,ERCP+EST combined therapy can effectively relieve the inflammatory response,and has little influence on liver function,and the incidence of complications is also lower,suggesting that this therapy can promote the recovery of patients'disease and has a significant therapeutic effect.