ERCP在急性胆源性胰腺炎急性反应期中的临床价值研究

目的:探讨ERCP在急性胆源性胰腺炎急性反应期中的临床价值.方法:回顾性分析2013年6月至2016年5月在我院消化内科治疗的急性胆源性胰腺炎患者108例,按照治疗方式的不同,分为对照组以及观察组,对照组采用常规非手术治疗措施,观察组在此基础上再辅之以行急诊ER-CP治疗.比较两组患者的近期临床疗效,两组患者不同时间点APACHEⅡ评分以及并发症发生情况,两组患者治疗7d后各实验室指标变化.结果:观察组患者的体温恢复正常时间、腹痛缓解时间以及肠道通气时间均较对照组降低,差异具有统计学意义(P<0.05).两组患者APACHEⅡ评分在入院治疗后均逐渐好转,观察组患者在入院治疗后第7天时APACHEⅡ评分好于对照组,差异具有统计学意义(P<0.05),观察组患者的并发症发生情况低于对照组,差异具有统计学意义(P<0.05).两组患者治疗1周后,观察组患者的感染指标(白细胞计数及C反应蛋白),肝功能(总胆红素、谷丙转氨酶及γ谷氨酰转肽酶)以及电解质(血糖及血钙)均较对照组好转,差异具有统计学意义(P<0.05).结论:ERCP治疗处于急性反应期的急性胆源性胰腺炎,能有效改善实验室指标,提高临床治疗疗效,有助于急性胆源性胰腺炎的转归.

The Clinical Value of Endoscopic Retrograde Cholangiopancreatography in the Acute Reaction of Acute Biliary Pancreatitis

Objective:To explore the clinical value of Endoscopic Retrograde Cholangiopancreatography in the acute reaction of acute biliary pancreatitis. Methods:108 cases of acute biliary pancreatitis treated in our hospital from June 2013 to May 2016 were retrospectively analyzed. According to the different treatment methods, the patients were divided into control group and observation group. The control group received con-ventional non-surgical treatment,the observation group supplemented by emergency line ERCP treatment on the basis of conventional non-surgical treatment . The APACHE Ⅱ score and the incidence of complications were compared between the two groups at different time points. The laboratory indexes of the two groups were measured after 7 days of treatment. Results: The recovery time of normal body temperature, abdominal pain relief time and intestine ventilation time in the observation group were significantly lower than those in the con-trol group ( P <0.05) . The APACHEⅡscore of the two groups were improved gradually after admission. The APACHE Ⅱ score of the observation group was significantly better than that of the control group on the 7th day after admission ( P <0.05) . The incidence of complications in the observation group was significantly lower than that of the control group P <0.05) . After 1 week of treatment, the infection index ( white blood cell count and C-reactive protein) , liver function ( total bilirubin, alanine aminotransferase and γ-glutamyltranspeptid-ase) and electrolytes ( blood glucose and serum calcium ) were significantly improved compared with the con-trol group ( P <0.05) . Conclusion: ERCP is an effective treatment for acute biliary pancreatitis, which can improve the laboratory indexes and improve the clinical curative effect, which is helpful for the outcome of a-cute biliary pancreatitis.