EST、ENBD聯(lián)合連續(xù)血液濾過治療重度急性胰腺炎的臨床分析
發(fā)布時(shí)間:2018-06-29 14:50
本文選題:連續(xù)血液凈化 + 內(nèi)鏡下十二指腸乳頭括約肌切開術(shù); 參考:《重慶醫(yī)科大學(xué)》2014年碩士論文
【摘要】:目的:對(duì)應(yīng)用內(nèi)鏡下十二指腸乳頭括約肌切開術(shù)(Endoscopicsphincterotomy,EST)、經(jīng)內(nèi)鏡鼻膽管引流術(shù)(Endoscopic nasobiliarydrainage,ENBD)聯(lián)合連續(xù)血液濾過治療重度急性胰腺炎患者的臨床效果和意義進(jìn)行研究。 方法:回顧性分析過去10年余我院收治的179例重度急性胰腺炎患者的臨床資料。根據(jù)其治療方式不同患者分為4組,常規(guī)組給予內(nèi)科常規(guī)醫(yī)療,CBP組在常規(guī)治療的基礎(chǔ)上行血液凈化,內(nèi)鏡組在常規(guī)治療的基礎(chǔ)上行EST、ENBD治療,聯(lián)合組行血液凈化和EST、ENBD。對(duì)比4組患者生命體征、白細(xì)胞、C反應(yīng)蛋白、APACHEⅡ評(píng)分、腹部體征變化情況、并發(fā)癥發(fā)生率、病死率及住院天數(shù)。 結(jié)果:與常規(guī)組比較,其余3組治療后各臨床指標(biāo)、APACHEⅡ評(píng)分、血淀粉酶水平、局部并發(fā)癥發(fā)生率、病死率及住院天數(shù)下降明顯(P0.05),腹部體征緩解的總有效率明顯高于常規(guī)組(P0.05);與其他3組相比,聯(lián)合組腹部體征緩解總有效率明顯升高(P0.05),,血淀粉酶水平、局部并發(fā)癥發(fā)生率及住院天數(shù)明顯降低(P0.05),病死率明顯低于常規(guī)組(P0.05),但與CBP組、內(nèi)鏡組比較差異不顯著(P>0.05)。 結(jié)論:持續(xù)血液濾過聯(lián)合EST、ENBD治療SAP能有效改善患者病情,對(duì)于減少并發(fā)癥、降低死亡率及縮短住院時(shí)間有積極有效的作用。
[Abstract]:Objective: to study the clinical effect and significance of endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) combined with continuous hemofiltration in the treatment of severe acute pancreatitis. Methods: the clinical data of 179 patients with severe acute pancreatitis in our hospital in the past 10 years were analyzed retrospectively. The patients were divided into 4 groups according to their treatment methods. The routine group was given routine medical treatment CBP group was given blood purification on the basis of routine treatment, the endoscopic group was treated with EST-ENBD on the basis of routine treatment, and the combined group was given blood purification and ESTENBD. The vital signs, the score of APACHE 鈪
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