發(fā)布時間：2018-03-02 11:49

  本文選題：急性膽源性胰腺炎　切入點：ERCP　出處：《廣西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的探討內(nèi)鏡下逆行胰膽管造影治療技術(endoscopic retrograde cholangiopancreatography,ERCP)在急性膽源性胰腺炎(acute biliary pancreatitis,ABP)診斷和治療中的應用。方法回顧性分析我院2012年1月1日~2016年12月31日153例急性輕癥膽源性胰腺炎且經(jīng)ERCP治療的ABP患者資料,按照從發(fā)病到內(nèi)鏡治療時間、急性胰腺炎的病程及我院收治患者實際情況,分為A組(7d治療組)42例,B組(≥7d且14d治療組)45例,C組(≥14d治療組)66例,分別對三組術后的腹痛癥狀完全消失時間,血清淀粉酶恢復正常時間,平均住院日、住院總費用、飲食恢復時間及并發(fā)癥、預后及對ERCP操作情況進行分析。結果A組患者在淀粉酶恢復正常、腹痛消失時間及住院天數(shù),飲食恢復時間均較B、C組患者時間短,A組患者住院費用較B、C組住院費用少;B組腹痛消失、淀粉酶及飲食恢復時間較C組時間短,B組較C組住院費用少;三組患者ERCP治療后,預后均為好轉,無死亡病例,并發(fā)癥及預后情況無統(tǒng)計學差異;ERCP在ABP患者中結石檢出率為92.15%,可發(fā)現(xiàn)CT、B超未能發(fā)現(xiàn)的泥沙樣結石及陰性結石。結論ERCP結石檢出率較CT、B超檢查高,尤其是在膽道泥沙樣結石方面,ERCP聯(lián)合CT或B超檢查可提高結石檢出率;ABP患者早期行ERCP治療是有效的,病情康復快,治療費用更少,住院時間縮短。
[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.

【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R576

【參考文獻】

相關期刊論文 前10條

1 王桂良;文萍;龔敏;文劍波;徐林芳;唐琳;;B超、CT、ERCP和MRCP對膽管微小結石診斷價值的比較[J];現(xiàn)代中西醫(yī)結合雜志;2012年25期

2 黃志強;;微創(chuàng)外科與損傷控制:重癥急性胰腺炎治療的變革[J];中華腔鏡外科雜志(電子版);2010年05期

3 金安琴;黃曉俊;王偉;馮彥虎;劉子燕;;早期內(nèi)鏡治療急性膽源性胰腺炎46例臨床研究[J];中國普外基礎與臨床雜志;2010年10期

4 王堅;張唏文;王昊陸;;膽總管末端嵌頓性結石治療策略[J];中國實用外科雜志;2010年05期

5 Dimitrios J Kapetanos;;ERCP in acute biliary pancreatitis[J];World Journal of Gastrointestinal Endoscopy;2010年01期

6 王穩(wěn)忠;黃鵬;王培勉;;血清生化指標對膽源性胰腺炎的診斷意義[J];中國實用醫(yī)藥;2008年10期

7 ;New precut sphincterotomy for endoscopic retrograde cholangiopancreatography in difficult biliary duct cannulation[J];World Journal of Gastroenterology;2007年32期

8 孔瑞,孫備;重癥急性胰腺炎微創(chuàng)治療的研究進展[J];國外醫(yī)學.外科學分冊;2005年06期

9 宮軻;腹腔鏡時代的胰腺外科[J];中國微創(chuàng)外科雜志;2005年07期

10 李兆申;急性胰腺炎內(nèi)鏡治療的價值及安全性[J];中國實用外科雜志;2005年06期

，

本文編號：1556396