【摘 要】
：
Background Acute severe biliary pancreatitis (ASBP) is a severe and fatal disease, and the expenditure is huge and therapeutic effects are still not satisfactory.This study aimed to improve the therap
【机 构】
：
Department Ⅱ of General Surgery, the First Hospital of Lanzhou University, the First Clinical Medica
【出 处】
：
2015第八届全国ERCP学术研讨会暨第十一届中国西部国际治疗内镜高峰论坛
论文部分内容阅读
Background Acute severe biliary pancreatitis (ASBP) is a severe and fatal disease, and the expenditure is huge and therapeutic effects are still not satisfactory.This study aimed to improve the therapeutic effects and reduce the expenditure of ASBP treatment.Methods One hundred and five patients diagnosed with ASBP were referred to our department from January 2004 to July 2009, Diagnosis was based on the 2007 criteria of the Chinese Society of Surgery.Patients were divided into two groups;the E group: 50 patients who underwent endoscopic retrograde choledochopancreatography (ERCP) + endoscopic sphincterotomy (EST) + endoscopic lithotripsy basket (ESR) +endoscopic retrograde biliary drainage (ERBD) and enteral nutrition (EN), and the R group: 55 patients who underwent traditional treatment without ERCP.Subsequently, subjective symptoms, signs, biochemical analysis, serum endotoxin, tumor necrosis factor α, grades by computed tomography (CT), cost of hospitalization and length of stay were compared between the two groups.Results All enrolled patients complied well with all therapeutic regimens.Endoscopic therapy that combined EN could significantly improve symptoms, clinical signs, laboratory values, tumor necrosis factor α and endotoxin while significantly reducing hospital expenditure and length of hospital stay.The experimental findings revealed that there were obvious advantages in the E group compared with the Rgroup.Conclusions Endoscopic therapy combined with EN is an effective, safe and economic therapeutic regimen of ASBP.
其他文献
不孕症正在成为继肿瘤和心脑血管病之后,严重影响人们生活与生殖健康的第三大疾病.吴克明教授认为临床诊治不孕症首先要明确病因,中医药治疗不孕症的优势在"调经为先,适时种子,及时保胎",针对生殖内分泌严重紊乱造成卵泡成熟和排卵障碍者应整合中西医两法提高疗效.
连续3次或3次以上的自然流产为复发性流产,85％发生于妊娠早期,且病因复杂,尚未完全明确,研究发现它与遗传,解剖,内分泌等相关,而不明原因的不孕患者抗子宫内膜抗体阳性率高达36.9％,它以子宫内膜为靶抗原,通过抗原抗体反应破坏子宫内膜结构影响胚胎的着床和发育,从而导致不孕及自然流产甚至复发性流产,中药在免疫治疗和保胎方面具有独到的优势,笔者现将导师魏绍斌教授治疗抗内膜抗体阳性的经验进行介绍。本例患
消化道重建术后发生胆管结石，采用胃镜、十二指肠镜、小肠镜、胆道镜、超声内镜等微创治疗，对单/双气囊小肠镜取石进行比较，分析了经皮胆道镜取石的局限性，如建立窦道所需时间较长，不能解决胰腺系统问题，合并腹水时不能行PTCD等。
联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)是近年提出的一种手术方式,分两次完成,第1次手术包括门静脉结扎、在待切除肝和需保留肝之间离断肝实质,待剩余肝脏体积增大后再行第2次手术切除病肝.ALPPS主要目的是使剩余肝脏体积快速增长,为那些原来不能切除的肝脏恶性肿瘤的患者提供可根治性切除的机会.本文从ALPPS概念的提出、手术方法、适用范围等方面进行了综述,并对以后的发展方向提出了展望.
作者将度旧乳头切开刀进行改良、重新利用,并将圈套器新用,共治疗胆胰疾患30例,总有效率达96.7％,治愈率达83.3％.使用这种改良乳头切开刀具有经济实惠、疗效可靠等优点.
目的：研究经内镜置入胰管、胆胰管支架对伴有高危危险因素的胆管结石患者术后胰腺炎的发生预防作用。方法：收集我科自2007年1月至2012年1月收治的458名合并存ERCP术后胰腺炎高危危险因素(性别、肥胖、既往急性胰腺炎病史、慢性胰腺炎、≥2次胰管显影、小乳头括约肌切开、针型刀预切开、困难插管、壶腹周围憩室、手术时间)的胆管结石患者资料,其中男性218名、女性240名,平均年龄63岁,最小20岁,最
目的：对于术后重建肠道病例的ERC相关技术,到达十二指肠乳头或者胆管空肠吻合部位的困难病例很多,因此操作完成率很低.可以通过双气囊内窥镜(double balloon endoscope；DBE)以期到达更远处的目标部位.有报道显示Short type DBE的出现使术后重建肠道病例的ERC相关手术的成功率得到了改善.名古屋大学医学部附属医院对使用DBE的ERC技术进行了回顾和检讨.方法：以201
Biliary complications are common syndrome after orthotopic liver transplantation (OLT) with occurrence up to 10％～30％[1].Benign biliary stricture is one of the most common biliary complications after O
目的：探讨血清、胆汁CA19-9水平在胰腺癌诊断中临床应用价值及最佳筛查界值.方法：对66例胰腺癌患者和85例胰腺良性疾病者测定胆汁和血清的CA19-9水平,并进行对比分析和评价.结果：胰腺癌组患者血清、胆汁CA19-9水平明显高于良性组患者(P＜0.05);根据ROC曲线胆汁CA19-9在胰腺癌的诊断价值优于血清,且各诊断指标均高于血清;两者联合检测灵敏度提高至70％.结论：通过内镜技术检测胆汁
胆肠吻合术是胆道系统的常见手术、可将肠袢或肠支上提与胆管作吻合、行胆汁引流。但肠袢胆肠吻合术.改变了胃肠道的解剖，食物易返流入胆道造成感染，故有人行胆肠吻合口以下的肠袢的侧侧吻合，以克服此缺点。此例病人属此情况.但由于吻合口过大，在肠蠕动紊乱时发生远端小肠套叠，以致肠坏死。由此病例可见。胆管与空肠袢的吻合不宜提倡。切忌胆肠吻合口以下肠袢侧-侧大口吻合。胆肠吻合术应以Roux-en-Y吻合术为优。