摘要
目的观察内镜治疗急性胆源性胰腺炎的疗效及其并发症。方法80例急性胆源性胰腺炎患者在抗炎抑酶等综合治疗的基础上,行内镜(1￣3d内)逆行胰胆管造影(ERCP)及经内镜十二指肠乳头括约肌切开(EST)或鼻胆管引流(ENBD)等治疗。结果经内镜治疗后72例(90%)急性轻症胆源性胰腺炎(MABP)患者2～5d体温恢复正常;急性重症胆源性胰腺炎(SABP)患者3～8d腹部体征好转,血常规、淀粉酶及血生化1、2周内基本恢复,平均住院18.7d。8例形成急性坏死性胰腺炎转外科手术,平均住院65.9d,3例死亡。内镜治疗过程中5例出现十二指肠乳头括约肌切口出血,经局部喷洒凝血酶止血外,未再出现其他并发症。结论急性胆源性胰腺炎早期ERCP及内镜治疗安全有效。
[Objective] To observe the success rate, theraputic effects and complications of endoscopic therapy in patients of Biliary obstructive Acute Pancreatitis（BOAP）. [Methods] Based on comprehensive treatment including anti-inflammatory and anti-enzyme therapy, 80 patients of BOAP who underwent ERCP, EST OR ENBD within 3 days were analyzed retrospectively. [Results] Among 80 patients who underwent endoscopic therapy, 90%（72/80） had favorable results. After therapy, patients who had fever came back to normal body temperature in 2-5 days, patients who had peritonitis had better physical sign in 3-8 days. All 72 patients turned to normal range of blood test results, biochemical test results and blood amylase level in 1-2 weeks and were discharged in 5-30 days. 10%（8/80） of 80 patients who had acute necrotic pancreatitis were transferred to surgical therapy. During endoscopic therapy, 5 patients presented incision site hemorrhage of sphincter of papilla of duodenum, no other complications were observed. [Conclusion] Early endoscopic therapy is safe and effective in BOAP patients,the therapy should be performed as early as possible to reduce the risk of severe acute pancreatitis.
出处
《中国内镜杂志》
CSCD
北大核心
2006年第7期692-694,共3页
China Journal of Endoscopy
