摘要
目的探讨急诊内镜治疗老年人胆源性重症急性胰腺炎(biliary severe acute pancreatitis, BSAP)的价值。方法25例老年人BSAP经内镜治疗(ERCP+EST或ENBD),与29例老年人BSAP手术治疗组进行比较,观察急诊内镜治疗老年人胆源性重症急性胰腺炎的临床疗效与安全性。结果内镜组的体温恢复时间、腹痛消失时间、上腹压痛消失时间、白细胞恢复正常时间、血清淀粉酶恢复正常时间、手术时间、住院时间、治愈率、死亡率、并发症发生率和复发率分别为3.6±1.3 d、6.4±2.2 d、8.2±3.4 d、6.5 ±2.4 d、7.3±2.1 d、37.5±6.5min、21.4±5.0d、72.0%、8.0%、16.0%和4.0%;而手术组分别为:6.5±1.6 d、10.0±3.8 d、15.8±4.2 d、11.2±3.8 d、13.5±4.8 d、132.6±34.5 min、33.0±6.8 d、51.7%、17.3%、37.9%和10.3%,两组相比,内镜组明显优于手术组,上述指标差异均有显著性(P<0.05);而肝功能恢复正常时间却无显著性差异(P>0.05)。结论内镜治疗BSAP具有微创有效,可分期分步进行治疗,清除胆道结石等优点,是治疗老年人BASP的首选方案。
Objective To investigate the clinical value of endoscopic therapy for patients with senile severe acute pancreatitis (BASP). Methods Fifty-four senile patients were enrolled and divided into two groups : endoscopic treatment group and operation group. The results of treatments were compared between two groups. Results The time for temperature to be normal, time for disappearance of abdomen pain, time for disappearance of tenderness, WBC to be normal, serum amylase to be normal, time of operation, hospital stay, cure rate, mortality, complication, frequency of recurrent pancreatitis were 3.6 ± 1.3 d、6.4 ± 2.2 d、8.2 ± 3.4 d、6.5 ± 2.4d、7.3 ± 2.1 d、37.5 ± 6.5 min、21.4 ± 5.0 d 、72.0%、8.0%、16.0% 和4.0% in the endoscopic therapy group, and 6.5 ± 1.6 d、10.0 ± 3.8 d、15.8 ± 4.2 d、11.2 ± 3.8 d、13.5 ± 4.8 d、132.6 ± 34.5 min、33.0 ± 6.8 d、 51.7%、 17.3%、37.9% and 10.3% in operation group, respectively. The differences between two groups were significant (P< 0.05). There was no significant difference in terms of time for function of liver to be normal (P > 0.05). Conclusion Endoscopic therapy is an ideal alternative for senile BASP, which is characterized by minimal injury, effectiveness and sequential process.
出处
《现代消化及介入诊疗》
2004年第2期70-73,共4页
Modern Interventional Diagnosis and Treatment in Gastroenterology
