无明显梗阻的急性胆源性胰腺炎的治疗方式体会

发布时间：2018-06-25 06:18

本文选题：急性胆源性胰腺炎 + 无梗阻　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:分析比较无明显梗阻的急性胆源性胰腺炎采取不同治疗方法的效果。方法:采取回顾并分析的方法,对于我从2009年9月-2014年6月就诊于我院的28位无明显梗阻的急性胆源性胰腺炎患者的临床资料,经胰腺炎治疗并恢复后采取两种不同治疗方案后的治疗效果进行对比研究。结果:患者经临床确诊为急性胆源性胰腺炎后,首先给予急性胆源性胰腺炎的保守治疗,并行磁共振胰胆管成像(MRCP)明确此患者是否有结石梗阻。选取经MRCP检查未发现胆总管结石梗阻的28例患者。经保守治疗至其急性胆源性胰腺炎恢复后,此28例患者中的11例(组1)行腹腔镜胆囊切除术(Laparoscopic Cholecystectomy,LC),17例(组2)行内镜逆行胆胰管造影(ERCP)、十二指肠乳头括约肌切开(EST)取石及鼻胆管引流(ENBD)保留胆囊治疗。组1患者,胰腺炎复发1人其余恢复良好。组2患者胰腺炎复发者3人,9人出现不同程度黄疸及肝胆区疼痛,6人二次手术摘除胆囊。结论:无明显梗阻的急性胆源性胰腺炎患者中,经胰腺炎治疗并恢复后行预防性胆囊切除术的患者,其胰腺炎的复发率及并发症的发生率有明显降低,其治疗效果较保留胆囊组的患者较好。
[Abstract]:Objective: to compare the effects of different treatments for acute biliary pancreatitis without obvious obstruction. Methods: the clinical data of 28 patients with acute biliary pancreatitis without obvious obstruction from September 2009 to June 2014 were reviewed and analyzed. The therapeutic effects of two different treatment regimens after treatment and recovery of pancreatitis were compared. Results: after clinical diagnosis of acute biliary pancreatitis, the patient was given conservative treatment of acute biliary pancreatitis, and MRCP was used to determine whether the patient had stone obstruction. Twenty-eight patients with common bile duct stone obstruction were selected by MRCP. After conservative treatment until the recovery of acute biliary pancreatitis, Of the 28 patients, 11 (group 1) underwent laparoscopic cholecystectomy (LC) and 17 (group 2) underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and cholecystectomy (ENBD). In group 1, pancreatitis recurred and others recovered well. In group 2, 3 patients with recurrent pancreatitis and 9 patients with varying degrees of jaundice and pain in hepatobiliary area were removed gallbladder by secondary operation. Conclusion: among the patients with acute biliary pancreatitis without obvious obstruction, the recurrence rate of pancreatitis and the incidence of complications were significantly decreased in the patients treated with pancreatitis and recovered after cholecystectomy. The therapeutic effect was better than that in the group of gallbladder preservation.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.51

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