急性胆源性胰腺炎内镜与传统治疗效果与安全性的随机对照观察

目的 比较内镜下治疗与传统治疗急性胆源性胰腺炎(ABP)的效果和安全性.方法 68例随机分为内镜组和传统组各34例(重症患者分别有9、8例),所有患者入院后即给予内科综合治疗,内镜组患者入院24 h内行十二指肠乳头括约肌切开术,传统组患者待病情稳定后择期手术.结果 内镜组:34例ABP的血常规、淀粉酶和血生化于1、2周内基本恢复;25例轻症者经内镜治疗后2～5d体温恢复正常;9例重症者3～8d腹部体征好转.传统组:34例中有6例行急症手术.内镜组的重症患者并发症发生率为11.1%(1/9);而传统组为50%(4/8),其数值是高于内镜组,但差异无统计学意义(P＞0.05).内镜组住院时间为(16.5±4.0)d,低于传统组的(54.0±37.0)d,差异有统计学意义(P＜0.05).结论 内镜下行微创治疗ABP的住院时间短且安全性好.

Comparison between endoscopic surgery and conventional treatment in acute biliary pancreatitis

Objective To observe the efficacy and safety of endoscopic surgery and conventional treatment in acute biliary pancreatitis(ABP).Methods Sixty-eight patients were randomly allocated to two groups,and then received endoscopic sphincterotomy(endoscopic group) during 24 h or conventional treatment(conservative group).Results Blood count,serum amylase and biochemical indexes recovered generally during 1-2 weeks in endoscopic group;of them,25 mild cases had normal temperature during 2-5 days,and 9 severe ones showed the improvement of abdominal signs during 3-8 days.Six cases underwent emergency operation in conservative group.There was no statistical difference in the complication of severe patients between both groups(P>0.05).The length of stay in conservative group was superior to that in endoscopic group(P<0.05).Conclusion Endoscopic sphincterotomy is safe and effective for ABP.