EST、ENBD联合连续血液滤过治疗重度急性胰腺炎的临床分析

发布时间：2018-06-29 14:50

  本文选题：连续血液净化 + 内镜下十二指肠乳头括约肌切开术　； 参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：对应用内镜下十二指肠乳头括约肌切开术（Endoscopicsphincterotomy,EST）、经内镜鼻胆管引流术（Endoscopic nasobiliarydrainage,ENBD）联合连续血液滤过治疗重度急性胰腺炎患者的临床效果和意义进行研究。 方法：回顾性分析过去10年余我院收治的179例重度急性胰腺炎患者的临床资料。根据其治疗方式不同患者分为4组，常规组给予内科常规医疗，CBP组在常规治疗的基础上行血液净化，内镜组在常规治疗的基础上行EST、ENBD治疗，联合组行血液净化和EST、ENBD。对比4组患者生命体征、白细胞、C反应蛋白、APACHEⅡ评分、腹部体征变化情况、并发症发生率、病死率及住院天数。 结果：与常规组比较，其余3组治疗后各临床指标、APACHEⅡ评分、血淀粉酶水平、局部并发症发生率、病死率及住院天数下降明显（P0.05），腹部体征缓解的总有效率明显高于常规组（P0.05）；与其他3组相比，联合组腹部体征缓解总有效率明显升高（P0.05），，血淀粉酶水平、局部并发症发生率及住院天数明显降低（P0.05），病死率明显低于常规组（P0.05），但与CBP组、内镜组比较差异不显著（P＞0.05）。 结论：持续血液滤过联合EST、ENBD治疗SAP能有效改善患者病情，对于减少并发症、降低死亡率及缩短住院时间有积极有效的作用。
[Abstract]:Objective: to study the clinical effect and significance of endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) combined with continuous hemofiltration in the treatment of severe acute pancreatitis. Methods: the clinical data of 179 patients with severe acute pancreatitis in our hospital in the past 10 years were analyzed retrospectively. The patients were divided into 4 groups according to their treatment methods. The routine group was given routine medical treatment CBP group was given blood purification on the basis of routine treatment, the endoscopic group was treated with EST-ENBD on the basis of routine treatment, and the combined group was given blood purification and ESTENBD. The vital signs, the score of APACHE 鈪

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