發(fā)布時(shí)間：2018-10-31 14:10

【摘要】：目的評(píng)估內(nèi)鏡清創(chuàng)術(shù)與外科清創(chuàng)術(shù)兩種方法治療胰腺壞死感染的臨床療效。方法回顧2009年6月至2016年6月新橋醫(yī)院消化科內(nèi)鏡中心完成的胰腺壞死感染內(nèi)鏡清創(chuàng)術(shù)患者34例為內(nèi)鏡組,以同時(shí)期西南醫(yī)院和大坪醫(yī)院完成的胰腺壞死感染外科清創(chuàng)術(shù)的患者34例為外科組,分析比較其臨床特征和治療效果。結(jié)果兩組手術(shù)成功率均為100%;內(nèi)鏡組的病死率為8.82%(3/34),顯著低于外科組41.18%(14/34)(P0.01);內(nèi)鏡組并發(fā)癥發(fā)生率11.76%(4/34),顯著低于外科組67.65%(23/34)(P0.01);兩組并發(fā)癥主要為出血、器官衰竭和休克,分別為2.94%(1/34)和61.76%(21/34)、0%(0/34)和41.18%(14/34)、2.94%(1/34)和47.06%(16/34),內(nèi)鏡組主要并發(fā)癥發(fā)生率低于外科組(P0.01);兩組復(fù)發(fā)率均為8.82%(3/34);內(nèi)鏡組的手術(shù)次數(shù)、住院時(shí)間、住院費(fèi)用均高于外科組,分別為2.62(1~10)次和1.06(1~2)次(P0.01)、83.5(7~175)d和54.2(2~154)d(P0.05)、35.18(2.81~147.61)萬元和21.84(3.33~74.27)萬元(P0.01)。結(jié)論胰腺壞死感染內(nèi)鏡清創(chuàng)術(shù)的并發(fā)癥和病死率顯著低于外科清創(chuàng)術(shù),內(nèi)鏡清創(chuàng)術(shù)的手術(shù)次數(shù)、住院時(shí)間和住院費(fèi)用均高于外科手術(shù)。
[Abstract]:Objective to evaluate the clinical efficacy of endoscopic debridement and surgical debridement in the treatment of pancreatic necrotic infection. Methods from June 2009 to June 2016, 34 patients with pancreatic necrotic infection underwent endoscopic debridement in the endoscopic center of Digestive Department, Xinqiao Hospital. Thirty-four cases of surgical debridement of pancreatic necrotic infection from Southwest Hospital and Daping Hospital of the same period were selected as surgical group. The clinical features and therapeutic effects were analyzed and compared. Results the operative success rate of the two groups was 100%, the mortality of the endoscopic group was 8.82% (3 / 34), which was significantly lower than that of the surgical group (41.18%, 14 / 34) (P0.01). The incidence of complications in endoscopic group was 11.76% (4 / 34), which was significantly lower than that in surgical group (67.65%, 23 / 34) (P0.01). The main complications in the two groups were bleeding, organ failure and shock, which were 2.94% (1 / 34) and 61.76% (21 / 34), 0% (0 / 34) and 41.18% (14 / 34), respectively. 2.94% (1 / 34) and 47.06% (16 / 34), the incidence of major complications in the endoscopic group was lower than that in the surgical group (P0.01). The recurrence rate of both groups was 8.82% (3 / 34). The number of operations, hospitalization time and hospitalization cost in endoscopic group were higher than those in surgical group (2.62 (1 / 10) and 1.06 (1 / 2) (P0.01), 83.5 (7 / 175) d and 54.2 (2n454) d (P0.05), respectively). 35.18 (2.81) 147.61 million yuan and 21.84 (3.33) 74.27 million yuan (P0.01). Conclusion the complications and mortality of endoscopic debridement of pancreatic necrotic infection were significantly lower than that of surgical debridement.
【作者單位】： 第三軍醫(yī)大學(xué)新橋醫(yī)院消化內(nèi)科;第三軍醫(yī)大學(xué)軍事預(yù)防醫(yī)學(xué)院熱帶醫(yī)學(xué)研究所;
【基金】：第三軍醫(yī)大學(xué)新橋醫(yī)院科研項(xiàng)目(2014YLC15)~~
【分類號(hào)】：R657.5

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