内镜早期治疗急性胆源性胰腺炎60例临床研究

目的：探讨内镜早期治疗急性胆源性胰腺炎（ABP）的临床疗效。方法：ABP患者120例,根据治疗方法的不同随机分为早期内镜治疗重症ABP组（Ⅰ组）、早期内镜治疗轻症ABP组（Ⅱ组）、保守治疗重症ABP组（Ⅲ组）以及保守治疗轻症ABP组（Ⅳ组）,每组30例,评价各组的临床疗效。结果：Ⅰ组及Ⅱ组恶心、呕吐、发热、腹痛等症状和体征以及TNF-α、C反应蛋白（CRP）、IL-6、IL-8、血淀粉酶、尿淀粉酶、直接胆红素、谷氨酰转肽酶、碱性磷酸酶等实验室检查指标,在治疗前后的改善情况显著优于其他2组,病程缓解时间也短（P〈0.05）;Ⅰ组和Ⅱ组的治疗总有效率为93.3%和90.0%,明显优于Ⅲ组的70.0%和Ⅳ组的76.7%（P〈0.05）。结论：对ABP患者采用内镜早期治疗,相比保守治疗更能有效改善患者的临床症状和体征,值得临床推广。

Clinical research on early endoscopic treatment for 60 examples of acute biliary pancreatitis

Objective: To investigate the early endoscopic treatment for acute biliary pancreatitis(ABP) clinical efficacy.Methods: 120 ABP patients,according to the different methods for treatment were randomly divided into early endoscopic treatment for severe ABP group(group I),early endoscopic treatment of mild ABP(Group II),conservative treatment in severe ABP group(Group III) and conservative treatment of mild ABP group(Group IV),30 cases in each group,evaluation clinical efficacy of each group.Results: Group I and group II nausea,vomiting,fever,abdominal pain and other symptoms and signs,and TNF-α,C reactive protein(CRP),IL-6,IL-8,serum amylase,urine amylase,direct bilirubin,valley GGT,alkaline phosphatase and laboratory examination indexes before and after treatment,the improvement was significantly better than the other 2 groups,duration of disease remission duration is shorter(P<0.05);group I,group II treatment the total effective rate was 93.3%,90%,was significantly better than that of group III 70.0% and group IV 76.7%(P<0.05).Conclusion: ABP patients using endoscopic treatment of early,compared to conservative treatment can effectively improve patients’ clinical symptoms and signs,worthy of clinical application.