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目的:评价治疗性逆行胰胆管造影术(ERCP)对重症急性胆源性胰腺炎(SABP)的疗效及安全性。方法:回顾分析65例SABP患者内镜治疗情况,比较早期及择期内镜治疗成功率、症状缓解及对预后的影响。结果:65例患者ERCP成功60例(成功率92.3%)。其中急诊ERCP成功率87.7%,择期ERCP成功率100%。33.83%ERCP未见胆管结石。对于无胆道梗阻的SABP患者,比较急诊与择期ERCP组患者的腹痛缓解、体温、白细胞计数、肝功能、淀粉酶等恢复正常时间无显著性差别(P>0.05)。结论:SABP行治疗性ERCP的诊治创伤小、有效。对于急性期SABP无明确胆道梗阻及感染,早期ERCP增加治疗风险及不成功率;病情稳定后择期ERCP可增加成功率并减少风险,不会加重病情。
Objective: To evaluate the curative effect and safety of ERCP in severe acute pancreatitis (SABP). Methods: A retrospective analysis of 65 cases of SABP endoscopic treatment, early and elective endoscopic treatment success rate, symptom relief and prognosis. Results: Sixty-five patients were successfully treated with ERCP (success rate 92.3%). The success rate of emergency ERCP 87.7%, elective ERCP success rate of 100%. 33.83% ERCP no bile duct stones. For SABP patients without biliary obstruction, there was no significant difference in abdominal pain, body temperature, white blood cell count, liver function, amylase, etc. between the emergency and elective ERCP patients (P> 0.05). Conclusion: SABP treatment of ERCP diagnosis and treatment of trauma, effective. For the acute phase of SABP without clear biliary obstruction and infection, early ERCP increased treatment risk and unsuccessful rate; stable elective ERCP can increase the success rate and reduce the risk, will not aggravate the condition.