摘要
目的:评价治疗性逆行胰胆管造影术(ERCP)对重症急性胆源性胰腺炎(SABP)的疗效及安全性。方法:回顾分析65例SABP患者内镜治疗情况,比较早期及择期内镜治疗成功率、症状缓解及对预后的影响。结果:65例患者ERCP成功60例(成功率92.3%)。其中急诊ERCP成功率87.7%,择期ERCP成功率100%。33.83%ERCP未见胆管结石。对于无胆道梗阻的SABP患者,比较急诊与择期ERCP组患者的腹痛缓解、体温、白细胞计数、肝功能、淀粉酶等恢复正常时间无显著性差别(P>0.05)。结论:SABP行治疗性ERCP的诊治创伤小、有效。对于急性期SABP无明确胆道梗阻及感染,早期ERCP增加治疗风险及不成功率;病情稳定后择期ERCP可增加成功率并减少风险,不会加重病情。
Objective： To evaluate the safety and therapeutic effect of endoscopic retrograde cholangiopancreatography （ERCP） for patients with severe acute biliary pancreatitis （SABP）. Methods： Treatment of ERCP for 65 cases with SABP was analyzed retrospectively. Successful rate, symptom relief and prognosis were compared between early and selective endoscopic treatment. Results： Sixty in 65 cases underwent ERCP were successful （successful rate 92. 3%）. The successful rate of emergency ERCP was 87. 7%, and selective ERCP were 100%. No bile duct stone was found in 3.3. 83% of patients with ERCP. There were no significant differences in recovery time for abdominal pain relief, temperature, white blood count, liver function and amylase enzyme value between emergency ERCP and selective ERCP in SABP patients without biliary obstruction （P〉0. 05）. Conclusions： Diagnosis and treatment with ERCP is effective and less traumatic in SABP patients. Early ERCP may increase the risk and unsuccessful rate in acute phase of SABP without absolute bile duct obstruction and infection. Selective ERCP may increase the successful rate and lower the risk after the patient＇s condition is stable.
出处
《内科急危重症杂志》
2011年第4期199-201,共3页
Journal of Critical Care In Internal Medicine
关键词
内窥镜逆行胰胆管造影术
重症急性胆源性胰腺炎
胆管结石
Endoscopic retrograde cholangiopancreatography Severe acute biliary pancreatitis Bile duct stone
