| 非梗阻性急性胆源性胰腺炎行ERCP/ES的临床意义 |
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| 引用本文： | 张健,杨正安,王进海,常建同,田明.非梗阻性急性胆源性胰腺炎行ERCP/ES的临床意义[J].宁夏医科大学学报,2011(11):1033-1035,1044. |
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| 作者姓名： | 张健 杨正安 王进海 常建同 田明 |
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| 作者单位： | 西安交通大学医学院第二附属医院干部病房四病区;西安交通大学医学院第二附属医院消化内科;西安交通大学医学院第二附属医院普通外科;西安医学院附属医院普通外科; |
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| 摘 要： | 目的探讨非梗阻性急性胆源性胰腺炎（acute biliary pancreatitis,ABP）患者急诊行逆行胰胆管造影和Oddi括约肌切开术（endoscopic retrograde cholangiopancreaticography and endoscopic sphincterotomy,ERCP/ES）治疗的效果和价值。方法 142例ABP患者中,轻型急性胆源性胰腺炎（mild acute biliary pancreatitis,MABP）93例,非梗阻性重症急性胆源性胰腺炎（severe acute biliary pancreatitis,SABP）49例。MABP和SABP各随机分为ERCP/ES治疗组和保守治疗组。保守治疗组常规行液体复苏、抑酸、抑酶、保肝、防治感染、早期肠内营养和中药等治疗,ERCP/ES组则在保守治疗基础上于入院24h内急诊行ERCP/ES。MABP和SABP分别比较ERCP/ES和保守治疗的效果,并随访2～3年比较胰腺炎的复发率。结果 MABP急诊行ERCP/ES与相应保守治疗组比较,ΔAPACHEⅡ、腹痛缓解时间、总住院时间、并发症发生率、病死率差异均无统计学意义（P〉0.05）,但胰腺炎复发率ERCP/ES较保守治疗组降低（P〈0.01）。SABP急诊行ERCP/ES与相应保守治疗组比较,ΔAPACHE、缓解腹痛、住院时间、并发症、病死率和胰腺炎的复发率差异均有统计学意义（均P〈0.05或P〈0.01）。结论 MABP急诊行ERCP/ES,对其并发症、病死率和预后等无明显益处,并有增加相关并发症的风险,而SABP急诊行ERCP/ES可显著改善病情,缩短住院时间,降低并发症和病死率。ABP行ERCP/ES可降低胰腺炎复发率。
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| 关 键 词： | 急性胆源性胰腺炎 内镜逆行胰胆管造影 内镜括约肌切开术 |
Clinical Significance of ERCP/ES in Patients with Non-obstructive Acute Biliary Pancreatitis |
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| ZHANG Jian,YANG Zheng-an,WANG Jin-hai,CHANG Jian-tong,TIAN Ming.Clinical Significance of ERCP/ES in Patients with Non-obstructive Acute Biliary Pancreatitis[J].Journal of Ningxia Medical College,2011(11):1033-1035,1044. |
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| Authors: | ZHANG Jian YANG Zheng-an WANG Jin-hai CHANG Jian-tong TIAN Ming |
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| Institution: | ZHANG Jian1,YANG Zheng-an1,WANG Jin-hai2,CHANG Jian-tong3,TIAN Ming4(1.The Fourth VIP Ward of the Second,the Affiliated Hospital of Medical School of Xi'an Jiaotong University,Xi'an 710004,2.the Gastroenterology Department of the Second Affiliated Hospital of Medical School of Xi'an Jiaotong University,3.the General Surgery Department of the Second Affiliated Hospital of Medical School of Xi'an Jiaotong University,4.The General Surgery Department of the Affiliated Hospital of Xi'an... |
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| Abstract: | Objective To investigate the efficacy and value of emergent(within 24h after admission) endoscopic retrograde cholangiopanereatography(ERCP)and endoscopic sphincterotomy(ES)in patients with non-obstructive acute biliary panereatitis(ABP).Methods 93 cases with non-obstructive mild acute biliary pancreatitis(MABP) were randomly divided into group A(45 cases,with treatment of ERCP/ES),group B(48 cases,with conservative treatment) and similar assignment was made to 49 cases of severe acute biliary pancreatitis(... |
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| Keywords: | acute biliary panereatitis(ABP) endoscopic retrograde cholangiopanereatography endoscopic sphincterotomy(ES) |
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