急性胆石性胰腺炎复发的预防方法论文.docVIP

　　急性胆石性胰腺炎复发的预防方法论文 .freely，简称EST)，将所有患者分为EST组和非EST组，并根据是否行胆囊切除术进一步分组，比较各组胆石性胰腺炎复发率。结果 平均随访18.5个月(6～30个月)。EST组38例，其中16例行胆囊切除术，均无胆石性胰腺炎复发(0/38)；非EST组74例，14例胆石性胰腺炎复发(14/74).freelethods of preventing the recurrence of acute gallstone pancreatitis 【Abstract】 Objective To explore the clinical methods of preventing the recurrence of acute gallstone pancreatitis.Methods From January 1999 to July 2001，the clinical data of 112 consecutive cases of cured acute gallstone pancreatitis ission all patients had no gallstone pancreatitis and cholecystectomy.All cases y) ed or not.The incidence of recurrent pancreatitis in each group onths.None had recurrent pancreatitis in all 38 cases of EST group (0/38)，including 16 cases undery，14 had recurrent pancreatitis in all 74 cases of non-EST group (14/74)，the recurrence rate y (intact gallbladder)，12 had recurrent gallstone pancreatitis (12/45)，the recurrence rate y，2 had recurrent gallstone pancreatitis (2/29)，the recurrence rate y (P＜0.05).The duration from patients discharge to recurrence y ed ERCP and EST，mon bile duct calculi ptoms of pancreatitis appeared.Conclusion EST is an effective and alternative method for preventing the recurrence of gallstone pancreatitis，and it is suitable for aged high-risk patients because of its minimally invasiveness.Cholecystectomy can reduce the recurrence rate of gallstone pancreatitis，mon bile duct calculi are the major cause of recurrent gallstone pancreatitis. 【Key y gallstone pancreatitis recurrence 急性胆石性胰腺炎是胆道结石的一个严重并发症，具有较高的病死率，并且常常反复发作。为防止胆石性胰腺炎复发，通常采取胆囊切除术。近年来，国外有文献报道可应用内镜下Oddi括约肌切开术(EST)来防止胆石性胰腺炎复发［1，2］，本文分析比较EST、胆囊切除术对预防胆石性胰腺炎复发的临床效果，旨在探讨防止胆石性胰腺炎复发的方法。 1 资料与方法 1.1 一般资料 1999年1月～2001年7月连续入院并治愈的112例急性胆石性胰腺炎患者，男48例，女64例，平均年龄68.8岁(29～82岁)。所有患者入院前均无胆石性胰腺炎病史且未行胆囊切除术，居住在上海市能够随访。胆石性胰腺炎的诊断标准除了有上腹部疼痛、血尿淀粉酶增高、CT证实有胰腺炎外，还必须有B超、CT证实有胆囊和(或)胆总管结石，实验室肝功能检查显示血清胆红素、ALT等升高，并能排除酒精性、高脂血症等其他原因。全组胆囊结石109例，同时合并胆总管结石35例，胆总管有结石、胆囊无结石3例。胆囊结石直径3～30mm不等，其中以4～10mm居多，胆囊结石数量1～80枚不等，以1～10枚居多。胆总管结石直径3～12mm，数量