胰管支架置入对急性胆源性胰腺炎患者预后及并发症的影响

Effect of pancreatic duct stenting on the prognosis and complications of acute biliary pancreatitis

目的分析急性胆源性胰腺炎(ABP)患者应用胰管支架置入治疗对预后及并发症的影响。方法选取2019年1月至2022年12月收治的300例ABP患者,按治疗方法不同分组,A组100例行鼻胆管引流治疗,B组100例行开腹胆总管探查联合T型管引流术治疗,C组100例行鼻胆管引流联合胰管支架置入治疗,对比3组肝功能、并发症、死亡率及恢复情况。结果B组术后总胆红素(TBIL)、天冬酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平低于A组(P<0.05);C组术后TBIL、AST、ALT水平低于A组和B组(P<0.05);B组恢复进食时间、体温恢复时间、住院时间较A组更短(P<0.05);C组恢复进食时间、腹痛消失时间、体温恢复时间及住院时间短于A组和B组(P<0.05);C组并发症发生率4.00%低于A组的12.00%(P<0.05);C组1.00%死亡率低于A组8.00%(P<0.05)。结论ABP患者应用胰管支架置入治疗,可有缩短患者恢复时间,有利于改善肝功能,死亡率低,且并发症少。

Objective To analyze the effect of pancreatic duct stenting on the prognosis and complications of acute biliary pancreatitis(ABP).Methods A total of 300 ABP patients admitted from January 2019 to December 2022 were selected.They were grouped according to different treatment methods,involving 100 patients treated with simple nasobiliary drainage in group A,100 patients treated with open common bile duct exploration combined with T-tube drainage in group B,and 100 patients treated with nasobiliary drainage combined with pancreatic duct stent placement in group C.Liver function,complications,mortality and recovery in the three groups were compared.Results Postoperative total bilirubin(TBIL),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in group B were significantly lower than those of group A(P<0.05),which,in group C were significantly lower than those of group A and B(P<0.05).The time to resume feeding,temperature recovery and hospitalization in group B were significantly shorter than those of group A(P<0.05),the time to resume feeding,abdominal pain disappearance,temperature recovery,hospitalization in group C were significantly shorter than those of group A and group B(P<0.05).The complication rate(4.00%vs 12.00%,P<0.05)and mortality(1.00%vs 8.00%,P<0.05)were significantly lower in group C than those of group A.Conclusion The application of pancreatic duct stenting in ABP patients can have shortened recovery time,facilitate improvement of liver function,and lower mortality rate and incidence of complications.