内镜治疗急性重症胰腺炎的价值(附26例临床分析)

目的评估内镜对急性重症胰腺炎(ASP)的治疗价值及应用指征。方法采用经内镜鼻胆管引流(ENBD)及经内镜乳头括约肌切开术(EST)等内镜技术治疗ASP26例。按下列指标评估腹痛消失时间、血淀粉酶复常时间、死亡率、平均住院日。结果腹痛消失时间内镜治疗组(治疗组)(2.5±1.5)d，而对照组(5.1±2.4)d,P<0.05；血淀粉酶复常时间治疗组(2.8±1.3)d，对照组为(4.8±1.8)d,P<0.05；病死率治疗组1/26(3.85%)，对照组5/30(16.67%)，P<0.05；平均住院日治疗组(17.2±5.2)d，对照组(26.2±18.2)d，P<0.05。结论ENBD加EST治疗以微小创伤达到满意外科引流效果，能够有效地降低胆胰管内压，缓解胰腺病变，起到治疗作用，不失为ASP治疗手段和方法上的一个补充，具有一定的临床使用价值。

VALUE OF ENDOSCOPIC IN THE TREATMENT OF ACUTE SEVERE PANCREATITIS: CLINICAL ANALYSIS OF 26 CASES

Objective:To assess the value and indication of endoscopic intervention for acute severe pancreatitis(ASP).Methods:A series of consecutive patients with (26 cases) was treated mainly with endoscopic naso-biliary drainage(ENBD),sphincterotomy (EST) as well as drugs,Abdominal pain duration:raised serum amylase period surgical intervention rate mortality rate and average be in hospital number of days.Results:Abdominal pain duration was (2.5±1.5) days in treatment group with endoscopic and (5.1±2.4) days in control group respectively (P<0.05),raised serum amylase period was (2.8±1.3) days in treatment group with endoscopic and (4.8±1.8) days period in control group respectively(P<0.05),mortality rate was 3.85% (1/26) in treatment group with endoscopic while 16.67% (5/30),P<0.05,average be in hospital number of days was (17.2±5.2) days in treatment group with endoscopic and (26.2±18.2) days in control group respectively.Conclusion:ENBD+EST the intraductal pressure can be lowered and the cause of occlusion be relieved with therapeutic effect.It is considered that endoscopic intervention is a practic of choice for selected.