摘要
目的评价在内镜逆行胰胆管造影下胰管支架治疗高三酰甘油血症性胰腺炎(HTGP)患者的有效性和安全性。方法回顾性分析宁夏医科大学总医院2017年1月1日至2020年6月1日期间收治的66例HTGP患者的临床资料。依据治疗方法分为两组:保守组(n=46)和支架组(n=20)。对比两组患者并发症发生率、转重症监护室(ICU)加强治疗率、入院48 h急性生理与慢性健康(APACHE)II评分、甘油三酯水平、抑酶药使用时间等。结果共入选HTGP患者66例,其中男性53例,女性13例,年龄(39.3±9.7)岁。两组均无死亡病例,支架组20例患者均成功完成胰管支架置入。与治疗前相比,保守组和支架组患者治疗后的白细胞、淀粉酶、甘油三酯、APACHE II评分均降低,差异有统计学意义(P<0.05)。治疗后支架组患者的APACHE II评分低于保守组[2.00(2.00,4.00)比4.00(3.00,5.25)分],差异有统计学意义(P<0.05)。支架组患者禁食天数、住院时间、抑酶药使用时间均低于保守组,差异有统计学意义(P<0.05)。支架组并发症发生率低于保守组[10.0%(2/20)比41.3%(19/46)],差异有统计学意义(P<0.05)。结论胰管支架治疗可以快速缓解HTGP患者的临床症状、减少住院时间、改善患者预后,是一种安全有效的治疗策略。
Objective To evaluate the effectiveness and safety of pancreatic duct stent under endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of patients with hypertriglyceridemic pancreatitis(HTGP).Methods The clinical data of 66 patients with HTGP at the General Hospital of Ningxia Medical University from January 1,2017 to June 1,2020 were retrospectively analyzed.The patients were divided into two groups according to treatment methods:conservative group(n=46)and stent group(n=20).The incidence of complications,the rate of transfer to the intensive care unit(ICU)for intensive treatment,the acute physiology and chronic health evaluation(APACHE)II score at 48 hours after admission,the level of triglycerides,and the application interval of enzyme inhibitor were compared between groups.Results There were 53 males and 13 females,aged(39.3±9.7)years.There were no deaths in both groups,all 20 patients in the stent group underwent successful pancreatic duct stenting.Compared with before treatment,the level of blood white blood cell,amylase,triglycerides,and APACHE II scores of patients in the conservative group and the stent group were both significantly reduced after treatment(P<0.05).After treatment,the APACHE II score of stent group patients was significantly lower than that of the conservative group[2.00(2.00,4.00)vs 4.00(3.00,5.25),P<0.05].The length of fasting,hospitalization,and the enzyme inhibitor application of patients in the stent group were significantly lower than conservative group(P<0.05).The complication rate of the stent group was significantly lower than conservative group[10.0%(2/20)vs 41.3%(19/46),P<0.05].Conclusion Pancreatic duct stenting can quickly relieve clinical symptoms of HTGP patients,reduce length of hospital stay and improve prognosis,which means it is a safe and effective treatment strategy for HTGP.
作者
赵成思
姚维杰
杨亚飞
兰柱
彭波
王佐正
Zhao Chengsi;Yao Weijie;Yang Yafei;Lan Zhu;Peng Bo;Wang Zuozheng(Department of Hepatobiliary Surgery,the General Hospital of Ningxia Medical University,Yinchuan 750004,China;Graduate School of Ningxia Medical University,Yinchuan 750004,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2021年第8期589-593,共5页
Chinese Journal of Hepatobiliary Surgery
基金
宁夏自治区重点研发计划项目(2020BEG02002,2021BEG03042)
宁夏自治区科技惠民计划项目(2021CMG03013)。
关键词
胰腺炎
急性坏死性
高脂血症
甘油三酯类
支架
Pancreatitis,acute necrotizing
Hyperlipidemias
Triglycerides
Stents
