急性胆源性胰腺炎诊疗中内镜逆行胰胆管造影术应用.docVIP

急性胆源性胰腺炎诊疗中内镜逆行胰胆管造影术应用 　　[摘要] 目的 探讨内镜逆行胰胆管造影术（ ERCP）在急性胆源性胰腺炎（ABP） 患者诊断与治疗中的应用价值。方法 收集84例ABP患者的临床资料，分为观察组与对照组，各42例，观察组给予 ERCP诊断，并于内镜下乳头括约肌切开术（EST ）或（和）内镜下鼻胆管引流术（ENBD） 治疗，对照组给予常规治疗。结果 观察组患者均成功行ERCP 检查，其中胆总管结石36例，十二指肠乳头处结石嵌顿6例。观察组的腹痛缓解时间、肠道恢复通气时间、血淀粉酶恢复正常时间及住院时间均显著短于对照组，差异有统计学意义（P0.05）；两组患者无出现死亡病例，观察组治疗的总有效率为95.24%，显著高于对照组的76.19%，差异有统计学意义（P0.05）。结论 对ABP患者行ERCP检查与治疗的成功率较高，能有效促进患者病情的恢复，疗效显著，值得推广。 　　[关键词] 急性胆源性胰腺炎；内镜逆行胰胆管造影术；鼻胆管引流术 　　[中图分类号] R657.51 [文献标识码] A [文章编号] 1674-0742（2014）11（c）-0053-02 　　[Abstract] Objective To study the value of endoscopic retrograde cholangiopancreatography （ERCP） applied to the diagnosis and treatment of acute biliary pancreatitis （ABP）. Methods The clinical data of 84 cases with ABP were selected. The patients were divided into the observation group and the control group with 42 cases in each. Patients in the observation group were diagnosed by ERCP， and treated by endoscopic sphincteropapillotomy（EST） or （and） endoscopic nasobiliary drainage （ENBD）， while patients in the control group were treated by the conventional treatment. Results All the patients in the observation group underwent the ERCP examination successfully. Of them， 36 cases had common bile duct calculi， and 6 cases had duodenal papilla calculus incarcerated. The abdominal pain relief time， the time for intestinal tract recovering ventilation， blood amylase returning to normal time and length of stay of the observation group were much shorter than those of the control group with statistically significance （P0.05）. No death occurred in both groups. The total effective rate of the observation group was 95.24%， significantly higher than the control groups 76.19% with statistical significance （P0.05）. Conclusion The success rate of ERCP examination and treatment is high in patients with ABP， which can effectively promote the recovery of patients， the curative effect is distinct， so it is worthy of promotion. 　　[Key words] Acute biliary pancreatitis； Endoscopic retrograde ch