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

【摘要】：目的探討內(nèi)鏡下逆行胰膽管造影治療技術(shù)(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(yīng)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(shí)間、急性胰腺炎的病程及我院收治患者實(shí)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(duì)三組術(shù)后的腹痛癥狀完全消失時(shí)間,血清淀粉酶恢復(fù)正常時(shí)間,平均住院日、住院總費(fèi)用、飲食恢復(fù)時(shí)間及并發(fā)癥、預(yù)后及對(duì)ERCP操作情況進(jìn)行分析。結(jié)果A組患者在淀粉酶恢復(fù)正常、腹痛消失時(shí)間及住院天數(shù),飲食恢復(fù)時(shí)間均較B、C組患者時(shí)間短,A組患者住院費(fèi)用較B、C組住院費(fèi)用少;B組腹痛消失、淀粉酶及飲食恢復(fù)時(shí)間較C組時(shí)間短,B組較C組住院費(fèi)用少;三組患者ERCP治療后,預(yù)后均為好轉(zhuǎn),無死亡病例,并發(fā)癥及預(yù)后情況無統(tǒng)計(jì)學(xué)差異;ERCP在ABP患者中結(jié)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(jié)石及陰性結(jié)石。結(jié)論ERCP結(jié)石檢出率較CT、B超檢查高,尤其是在膽道泥沙樣結(jié)石方面,ERCP聯(lián)合CT或B超檢查可提高結(jié)石檢出率;ABP患者早期行ERCP治療是有效的,病情康復(fù)快,治療費(fèi)用更少,住院時(shí)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(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R576

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本文編號(hào)：1556396