内镜下鼻胰管引流治疗胰腺巨大假性囊肿的疗效分析

发布时间：2018-01-25 18:06

本文关键词： 内镜治疗鼻胰管引流胰腺假性囊肿　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：探讨经内镜鼻胰管引流(endoscopic nasopancreatic drainage, ENPD)治疗急性胰腺炎(Acute Pancreatitis, AP)巨大假性囊肿的安全性及有效性。方法：将2010年6月～2013年12月重庆医科大学附属第一医院57例AP伴胰腺巨大假性囊肿的患者纳入研究,分为两个治疗组,其中29例患者在保守治疗的基础上接受ENPD治疗(ENPD治疗组)；28例患者接受保守治疗,即对照组。回顾性分析两组患者在不同治疗方案下的治疗效果及并发症情况。结果：ENPD治疗组中,有2例患者因不能耐受鼻胰管分别于引流2天、5天后改用经皮穿刺引流。ENPD治疗组腹痛缓解时间、住院天数、体温及白细胞恢复正常的时间均短于保守治疗组,手术率、死亡率低于对照组,差异均有统计学意义(P0.05)。引流过程中有3例患者发生感染,但未出现胃肠道出血及穿孔等并发症,且引流完全(CT下未见胰腺假性囊肿)。结论：ENPD能有效减轻胰管压力,控制胰腺炎进展,减少并发症的发生,对于治疗胰腺巨大假性囊肿是安全有效的。
[Abstract]:Objective: to investigate endoscopic nasopancreatic drainage through endoscopic nasopancreatic drainage. ENPD) was used to treat acute Pancreatitis in acute pancreatitis. AP). Methods: from June 2010 to December 2013, 57 patients with AP associated with giant pseudocyst of pancreas in the first affiliated Hospital of Chongqing Medical University were included in the study. 29 patients were treated with ENPD on the basis of conservative treatment. 28 patients received conservative treatment, that is, the control group. Retrospective analysis of the two groups of patients in different treatment plans under the treatment of the results and complications. Results: ENPD treatment group. Two patients were treated with percutaneous puncture drainage after 2 days of drainage. The duration of abdominal pain relief and hospital stay in the ENPD treatment group were analyzed respectively because of intolerable nasopancreatic duct drainage for 2 days or 5 days. The recovery time of body temperature and white blood cells was shorter than that of the conservative treatment group. The operative rate and mortality were lower than those in the control group, and the difference was statistically significant (P 0.05). Infection occurred in 3 patients during drainage. However, there were no complications such as gastrointestinal bleeding and perforation, and no pancreatic pseudocyst was found under complete CT drainage. Conclusion: ENPD can effectively relieve pancreatic duct pressure, control the progression of pancreatitis, and reduce the incidence of complications. It is safe and effective for the treatment of giant pseudocyst of pancreas.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.52

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