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目的:探讨早期内镜治疗老年重症急性胆源性胰腺炎的临床疗效。方法:回顾性分析2010年7月—2013年7月收治的90例老年重症急性胆源性胰腺炎患者的临床资料,其中行内镜治疗患者52例作为观察组,行开放手术治疗患者38例作为对照组,观察对比两组患者的体温恢复正常时间、腹痛、腹部压痛消失时间、白细胞(WBC)、血清淀粉酶(AMY)、谷草转氨酶(ALT)、碱性磷酸酶(ALP)、直接胆红素(DBIL)恢复正常时间、手术时间、住院时间、治愈率、并发症发生率、复发率和病死率等。结果:观察组体温恢复正常时间、腹痛消失时间、腹部压痛消失时间、白细胞(WBC)、血清淀粉酶(AMY)恢复正常时间、手术时间、住院时间明显优于对照组,两组间差异有统计学意义(P<0.05);观察组治愈率明显高于对照组,病死率、复发率和并发症发生率明显低于对照组,两组间比较均有统计学意义(P<0.05)。结论:早期内镜治疗老年重症急性胆源性胰腺炎创伤小、疗效好,值得临床推广。
Objective: To investigate the clinical efficacy of early endoscopic treatment of elderly patients with severe acute biliary pancreatitis. Methods: The clinical data of 90 elderly patients with severe acute biliary pancreatitis admitted to our hospital from July 2010 to July 2013 were retrospectively analyzed. Among them, 52 patients undergoing endoscopic therapy were treated as observation group and 38 patients underwent open surgery As the control group, we observed the time of normal body temperature recovery, abdominal pain, disappearance of abdominal tenderness, white blood cells (WBC), serum amylase (AMY), aspartate aminotransferase (ALT), alkaline phosphatase (ALP) (DBIL) to restore normal time, operation time, hospital stay, cure rate, complication rate, recurrence rate and mortality. Results: The body temperature recovery time, abdominal pain disappearance time, abdominal tenderness disappear time, white blood cell (WBC), serum amylase (AMY) recovery time, operation time and hospital stay in observation group were significantly better than those in control group (P <0.05). The cure rate in the observation group was significantly higher than that in the control group. The mortality, recurrence rate and complication rate were significantly lower in the observation group than in the control group (P <0.05). Conclusion: Early endoscopic treatment of elderly patients with severe acute pancreatitis with less trauma and good curative effect is worthy of clinical promotion.