【摘要】：目的探討早期B超引導(dǎo)內(nèi)鏡下十二指腸乳頭括約肌切開術(shù)(EST)和鼻膽管引流(ENBD)術(shù)在妊娠期急性重癥胰腺炎治療中的價值。方法將38例妊娠期急性重癥胰腺炎患者按隨機法分為內(nèi)鏡治療組13例及對照組25例。內(nèi)鏡治療組在入院后72 h內(nèi)行B超引導(dǎo)內(nèi)鏡下EST和ENBD術(shù)以及多學(xué)科綜合治療,對照組僅行多學(xué)科綜合治療。比較兩組患者治療前和治療7 d后APACHEⅡ(急性生理和慢性健康評價指標Ⅱ)評分、谷草轉(zhuǎn)氨酶、總膽紅素和C反應(yīng)蛋白差異,以及腹痛緩解時間、腸功能恢復(fù)時間、30 d內(nèi)胰腺假性囊腫、胰腺膿腫以及全身并發(fā)癥發(fā)生率和終止妊娠率、住院天數(shù)的差異。結(jié)果兩組治療前APACHEⅡ評分、谷草轉(zhuǎn)氨酶、總膽紅素和C反應(yīng)蛋白差異無顯著性(P0.05),內(nèi)鏡治療組7 d后APACHEⅡ評分(6.68±1.38)分,谷草轉(zhuǎn)氨酶(128.38±60.93)u/L,總膽紅素(44.62±15.59)mmol/L,C反應(yīng)蛋白(84.08±26.06)mmol/L;腹痛緩解時間(9.57±2.09)d,腸功能恢復(fù)時間(12.74±2.52)d。30 d內(nèi)胰腺假性囊腫、胰腺膿腫和全身并發(fā)癥發(fā)生率分別30.8%、7.7%和21.1%;終止妊娠率69.2%和住院天數(shù)(38.32±8.56)d,比較對照組明顯下降,差異有顯著性(P0.05)。結(jié)論妊娠期急性重癥胰腺炎患者給予早期72 h以內(nèi)B超引導(dǎo)內(nèi)鏡下十二指腸乳頭括約肌切開術(shù)(EST)和鼻膽管引流(ENBD)術(shù)安全、可行,治療效果明顯。
[Abstract]:Objective to evaluate the value of early endoscopic sphincterotomy (EST) and nasobiliary drainage (ENBD) in the treatment of severe acute pancreatitis complicating pregnancy. Methods 38 patients with severe acute pancreatitis in pregnancy were randomly divided into endoscopic treatment group (n = 13) and control group (n = 25). The endoscopic treatment group received EST and ENBD under B-ultrasound guidance and multi-disciplinary comprehensive therapy within 72 hours after admission, while the control group only received multi-disciplinary comprehensive therapy. The scores of APACHE 鈪，

本文編號：2145202