内镜清创术与外科清创术治疗胰腺坏死感染的回顾性研究

发布时间：2018-10-31 14:10

【摘要】：目的评估内镜清创术与外科清创术两种方法治疗胰腺坏死感染的临床疗效。方法回顾2009年6月至2016年6月新桥医院消化科内镜中心完成的胰腺坏死感染内镜清创术患者34例为内镜组,以同时期西南医院和大坪医院完成的胰腺坏死感染外科清创术的患者34例为外科组,分析比较其临床特征和治疗效果。结果两组手术成功率均为100%;内镜组的病死率为8.82%(3/34),显著低于外科组41.18%(14/34)(P0.01);内镜组并发症发生率11.76%(4/34),显著低于外科组67.65%(23/34)(P0.01);两组并发症主要为出血、器官衰竭和休克,分别为2.94%(1/34)和61.76%(21/34)、0%(0/34)和41.18%(14/34)、2.94%(1/34)和47.06%(16/34),内镜组主要并发症发生率低于外科组(P0.01);两组复发率均为8.82%(3/34);内镜组的手术次数、住院时间、住院费用均高于外科组,分别为2.62(1~10)次和1.06(1~2)次(P0.01)、83.5(7~175)d和54.2(2~154)d(P0.05)、35.18(2.81~147.61)万元和21.84(3.33~74.27)万元(P0.01)。结论胰腺坏死感染内镜清创术的并发症和病死率显著低于外科清创术,内镜清创术的手术次数、住院时间和住院费用均高于外科手术。
[Abstract]:Objective to evaluate the clinical efficacy of endoscopic debridement and surgical debridement in the treatment of pancreatic necrotic infection. Methods from June 2009 to June 2016, 34 patients with pancreatic necrotic infection underwent endoscopic debridement in the endoscopic center of Digestive Department, Xinqiao Hospital. Thirty-four cases of surgical debridement of pancreatic necrotic infection from Southwest Hospital and Daping Hospital of the same period were selected as surgical group. The clinical features and therapeutic effects were analyzed and compared. Results the operative success rate of the two groups was 100%, the mortality of the endoscopic group was 8.82% (3 / 34), which was significantly lower than that of the surgical group (41.18%, 14 / 34) (P0.01). The incidence of complications in endoscopic group was 11.76% (4 / 34), which was significantly lower than that in surgical group (67.65%, 23 / 34) (P0.01). The main complications in the two groups were bleeding, organ failure and shock, which were 2.94% (1 / 34) and 61.76% (21 / 34), 0% (0 / 34) and 41.18% (14 / 34), respectively. 2.94% (1 / 34) and 47.06% (16 / 34), the incidence of major complications in the endoscopic group was lower than that in the surgical group (P0.01). The recurrence rate of both groups was 8.82% (3 / 34). The number of operations, hospitalization time and hospitalization cost in endoscopic group were higher than those in surgical group (2.62 (1 / 10) and 1.06 (1 / 2) (P0.01), 83.5 (7 / 175) d and 54.2 (2n454) d (P0.05), respectively). 35.18 (2.81) 147.61 million yuan and 21.84 (3.33) 74.27 million yuan (P0.01). Conclusion the complications and mortality of endoscopic debridement of pancreatic necrotic infection were significantly lower than that of surgical debridement.
【作者单位】：第三军医大学新桥医院消化内科;第三军医大学军事预防医学院热带医学研究所;
【基金】：第三军医大学新桥医院科研项目(2014YLC15)~~
【分类号】：R657.5

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