在教学中贯穿轻型胆源性胰腺炎的治疗新理念

目的探讨加速康复理念在轻症胆源性胰腺炎治疗中的效果、安全性及在教学中的应用。方法随机将60例急性轻症胆源性胰腺炎患者分为加速康复（ER）组与常规恢复（TE）组。ER治疗策略主要包括：早期手术、把握ERCP的绝对指证及早期肠内营养。比较两组的并发症发生率、再住院率、住院时间及住院费用。结果ER组平均住院时间和住院费用明显低于TR组：5．9天vs．10．6天（P〈0．01）；平均住院费用￥10，023vs．￥15，035（P〈0．01）。两组再住院率及并发症发生率无差异。结论加速康复理论可以安全有效的应用于轻症胆源性胰腺炎的治疗。早期手术、遵循ERCP的绝对指证及早期肠内营养策略的实施能够在不增加手术并发症及再住院率的情况下，明显减少住院时间及住院费用。在临床教学中应该注意上述理论的诠释及应用。

Treatment Concept of Mild gallstone Pancreatitis in Clinical Teaching

Objective To discuss the application effect and safety of ER concept in the treatment of mild biliary pancreatitis. Methods Sixty cases of mild gallstone pancrcatitis are divided into two groups which are ER group and TR group. The ER treatment strategies are including early operation, the absolute indications of ERCP and early enteral nutrition. The complications, and hospital admission rates, length of hospital stay and cost in hospital of two groups are compared. Results The average length of hospital stay and the hospitalization expenses of ER group are significantly lower than the TR group： 5.9days vs. 10.6days （ P 〈 0.01 ） ; ￥ 10, 023 vs. ￥ 15,035 （ P 〈 0.01）. There were no significant difference in complications and readmission rates of the two groups. Condusion The new concepts of ER can be used in treatment of mild biliary pancreatitis safely and efficiently. The implementation of early operation, the absolute indications of ERCP and early enteral nutrition can significantly reduce the time in hospital and the hospitalization expenses without increase the rate of complications and readmission. We should pay attention to the application of such concepts in clinical teaching.