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目的探讨治疗性内镜辅助下内镜逆行性胰胆管造影(ERCP)术对胆源性胰腺炎并发症的影响。方法收集2012年9月至2014年6月收治的胆源性胰腺炎患者30例,采用随机数字法分为对照组与观察组,每组15例,对照组采用常规治疗法,观察组采用治疗性内镜辅助下ERCP术治疗,比较两组患者治疗前后APACHEⅡ评分和Ranson评分、淀粉酶恢复时间、C-反应蛋白(CRP)水平、腹痛腹痛缓解时间和并发症发生率。结果观察组治疗后APACHEⅡ评分为(6.18±0.88)分,对照组为(9.58±1.13)分,差异有统计学意义(P<0.05);观察组治疗后Ranson评分为(2.02±0.03)分,对照组为(2.75±0.05)分,差异有统计学意义(P<0.05);观察组CRP水平为(6.71±0.07)mg/L,对照组为(9.85±1.13)mg/L,差异有统计学意义(P<0.05);观察组淀粉酶恢复时间为(8.24±2.07)d,对照组为(11.04±3.31)d,差异有统计学意义(P<0.05);观察组腹痛缓解时间为(7.53±1.57)d,对照组为(11.31±2.78)d,差异有统计学意义(P<0.05);观察组并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论治疗性内镜辅助下ERCP术可有效改善胆源性胰腺炎患者的病情程度,快速改善患者的炎症状态和腹痛,并发症较少,治疗安全性高,值得推广应用。
Objective To investigate the effect of endoscopic retrograde cholangiopancreatography (ERCP) on the complication of biliary pancreatitis assisted by endoscopic therapy. Methods Thirty patients with gallstone pancreatitis were collected from September 2012 to June 2014. The patients were randomly divided into control group and observation group with 15 cases in each group. The control group was treated by conventional therapy and the observation group was treated by treatment Endoscopic ERCP assisted surgery, APACHE Ⅱ score and Ranson score, amylase recovery time, C-reactive protein (CRP) levels, abdominal pain and abdominal pain relief time and complication rates before and after treatment were compared between two groups. Results The APACHE Ⅱ score of the observation group was (6.18 ± 0.88) points after treatment and (9.58 ± 1.13) points after the treatment, the difference was statistically significant (P0.05). The Ranson score of the observation group after treatment was (2.02 ± 0.03) (2.75 ± 0.05) in the control group, the difference was statistically significant (P <0.05); the CRP level in the observation group was (6.71 ± 0.07) mg / L, and the control group was (9.85 ± 1.13) mg / L (P <0.05). The recovering time of amylase in the observation group was (8.24 ± 2.07) d and that in the control group was (11.04 ± 3.31) d, the difference was statistically significant (P <0.05) 7.53 ± 1.57) d, while the control group was (11.31 ± 2.78) d, the difference was statistically significant (P <0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P <0.05). Conclusions ERCP under therapeutic endoscopy can effectively improve the severity of gallstone pancreatitis, improve the inflammatory state and abdominal pain in patients with gallbladder disease. The complications are less and the treatment is safe. It is worth popularizing and applying.