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目的探讨内镜介入治疗对慢性胰腺炎的临床疗效。方法29例慢性胰腺炎患者行内镜介入治疗。其中,21例胰管扩张者行胰管括约肌切开(EPS);19例胰管有明显狭窄者置入胰管内支架(ERPD);12例副胰管扩张者则行副乳头括约肌切开并行副胰管内支架置入;8例胰管结石者先行EPS后用探条扩张狭窄段,再用网篮或气囊取石,若取石困难则做ERPD;平均每个月电话随访一次,必要时复查逆行胰胆管造影(ERCP)。结果内镜介入治疗成功率86.21%(25/29)。术后1、6、12个月时腹痛完全缓解率分别为75.86%、65.52%、68.97%;消瘦、脂肪泻等症状均不同程度得到改善,2例患者分别于术后第5个月及第11个月出现支架阻塞予更换支架治疗。术后并发一过性高淀粉酶血症7例,急性胰腺炎2例,出血2例,无穿孔发生,无中转手术或死亡。结论内镜介入治疗具有安全、有效、创伤小的优点,在治疗慢性胰腺炎方面应有较好的应用前景。
Objective To investigate the clinical effect of endoscopic interventional therapy on chronic pancreatitis. Methods Twenty-nine patients with chronic pancreatitis underwent endoscopic intervention. Among them, pancreatic duct sphincterotomy (EPS) was performed in 21 cases of pancreatic duct dilators; pancreatic duct stent (ERPD) was placed in 19 cases of pancreatic duct stenosis and pancreatic duct stenosis in 12 cases of pancreatic duct dilatation Pancreatic duct stents were implanted in 8 cases; pancreatic duct stones were preliminarily performed with EPS after expansion of the stenosis section, and then baskets or balloons were used to get stones; if the stones were difficult, ERPD was performed; on average, follow-up calls were made every month and the retrograde retrograde examination was performed if necessary Cholangiopancreatography (ERCP). Results The success rate of endoscopic interventional therapy was 86.21% (25/29). The complete remission rates of abdominal pain at 1, 6 and 12 months after operation were 75.86%, 65.52% and 68.97%, respectively. The symptoms such as weight loss and steatorrhea were improved to varying degrees. The 2 patients were treated at the 5th month and the 2nd 11 months appeared stent blockage to replace the stent treatment. Postoperative complications of transient amyloidosis in 7 cases, 2 cases of acute pancreatitis, bleeding in 2 cases, no perforation, no transit surgery or death. Conclusion Endoscopic interventional therapy is safe, effective and has the advantages of less trauma and better application prospect in the treatment of chronic pancreatitis.