Chen Wei-Xing, Li You-Ming, Gao Dao-Jian, Xiang Zun, Yu Chao-Hui, Xu Guo-Qiang, Ji Feng
Department of Gastroenterology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
World J Gastroenterol. 2005 Jun 21;11(23):3636-9. doi: 10.3748/wjg.v11.i23.3636.
To elucidate the role of endoscopic sphincterotomy (EST) in the treatment of acute pancreatitis.
Ninety patients with acute pancreatitis were randomly divided into two groups: EST group and control group. All the patients underwent pancreatitis routine therapy, additionally the EST group was treated with EST and endoscopic naso-bile drainage (ENBD). The time of disappearance of abdominal symptoms and signs, normalization of amylase, hospitalization and absorption of acute fluid was recorded for all patients.
The time of disappearance of abdominal pain, normalization of blood and urine amylase and hospitalization was significantly shorter in EST group than in control group. The ratios of disappearance of fluid in mild acute pancreatitis patients was significantly higher in EST group (51.52%, 84.85%, 90.91%, 93.94%) than in the control group (0%, 30.30%, 69.70%, 72.73%, P<0.01 or P<0.05). When the ratios of reduction of fluid in severe acute pancreatitis patients of the EST group were compared (8.33%, 58.33%, 83.33%, 91.67%) with those in the control group (0%, 8.33%, 25% and 41.67%), there were significant differences.
The effect of EST+ENBD on acute pancreatitis with fluid is rather good.
阐明内镜下括约肌切开术(EST)在急性胰腺炎治疗中的作用。
将90例急性胰腺炎患者随机分为两组:EST组和对照组。所有患者均接受胰腺炎常规治疗,此外,EST组采用EST及内镜鼻胆管引流术(ENBD)治疗。记录所有患者腹部症状和体征消失的时间、淀粉酶恢复正常的时间、住院时间以及急性渗出液吸收情况。
EST组腹痛消失时间、血淀粉酶和尿淀粉酶恢复正常时间以及住院时间均明显短于对照组。轻度急性胰腺炎患者渗出液消失率EST组(51.52%、84.85%、90.91%、93.94%)明显高于对照组(0%、30.30%、69.70%、72.73%,P<0.01或P<0.05)。将EST组重症急性胰腺炎患者渗出液减少率(8.33%、58.33%、83.33%、91.67%)与对照组(0%、8.33%、25%、41.67%)比较,差异有统计学意义。
EST+ENBD治疗急性胰腺炎合并渗出液效果较好。