ERCP在急性胆源性胰腺炎诊断和治疗中的应用

发布时间：2018-03-02 11:49

本文选题：急性胆源性胰腺炎　切入点：ERCP　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨内镜下逆行胰胆管造影治疗技术(endoscopic retrograde cholangiopancreatography,ERCP)在急性胆源性胰腺炎(acute biliary pancreatitis,ABP)诊断和治疗中的应用。方法回顾性分析我院2012年1月1日~2016年12月31日153例急性轻症胆源性胰腺炎且经ERCP治疗的ABP患者资料,按照从发病到内镜治疗时间、急性胰腺炎的病程及我院收治患者实际情况,分为A组(7d治疗组)42例,B组(≥7d且14d治疗组)45例,C组(≥14d治疗组)66例,分别对三组术后的腹痛症状完全消失时间,血清淀粉酶恢复正常时间,平均住院日、住院总费用、饮食恢复时间及并发症、预后及对ERCP操作情况进行分析。结果A组患者在淀粉酶恢复正常、腹痛消失时间及住院天数,饮食恢复时间均较B、C组患者时间短,A组患者住院费用较B、C组住院费用少;B组腹痛消失、淀粉酶及饮食恢复时间较C组时间短,B组较C组住院费用少;三组患者ERCP治疗后,预后均为好转,无死亡病例,并发症及预后情况无统计学差异;ERCP在ABP患者中结石检出率为92.15%,可发现CT、B超未能发现的泥沙样结石及阴性结石。结论ERCP结石检出率较CT、B超检查高,尤其是在胆道泥沙样结石方面,ERCP联合CT或B超检查可提高结石检出率;ABP患者早期行ERCP治疗是有效的,病情康复快,治疗费用更少,住院时间缩短。
[Abstract]:Objective to explore the treatment technique of endoscopic retrograde cholangiopancreatography (endoscopic retrograde, cholangiopancreatography, ERCP) in the treatment of acute biliary pancreatitis (acute biliary, pancreatitis, ABP) application in diagnosis and treatment. Methods a retrospective analysis of our hospital in January 1, 2012 ~2016 year in December 31st 153 cases of mild acute biliary pancreatitis and treated by ERCP with ABP data according to, from the onset to endoscopic treatment time of acute pancreatitis patients admitted to our hospital course and the actual situation, divided into A group (7d group) 42 cases, group B (more than 7d and 14d treatment group) 45 cases, group C (14d treatment group) 66 cases, the three groups respectively after operation the symptoms of abdominal pain disappeared time, serum amylase returned to normal time, average hospitalization days, total hospitalization expenses, diet recovery time, complications, prognosis and analysis of ERCP operation. Results A patients in recovery of amylase, abdominal pain The disappearance time and hospital stay, diet recovery time were compared with B, C group of patients with a short time, hospitalization expenses compared with B A group, C group, B group and less hospitalization expenses; abdominal pain disappeared, amylase and diet recovery time than group C in short time, B group than in C group less hospitalization cost; three groups of patients after treatment of ERCP and the prognosis were improved, no deaths, no significant difference in complications and prognosis of ERCP in patients with ABP stones; the detection rate was 92.15%, CT was found, sand like stones and negative calculi. Conclusion ERCP ultrasound failed to find the stone detection rate is CT, ultrasonography is high, especially in the sand like stones of bile duct ERCP, combined with CT or ultrasound can improve the detection rate of calculi; ABP patients with early ERCP therapy is effective, fast recovery, less treatment cost, shorten the hospitalization time.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R576

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