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目的评价急性胆源性胰腺炎(ABP)早期内镜治疗的价值。方法ABP患者69例中,早期十二指肠镜治疗41例(D组),48h内行逆行胰胆管造影术、内镜下乳头括约肌切开后用网篮取石或碎石网篮碎石后气囊取石术及内镜下鼻胆管引流术;另外28例(C组)采用常规治疗。结果D组术后腹痛缓解快,24h血及尿淀粉酶开始降低,治疗的成功率为100%,未发生与内镜操作有关的严重并发症,住院时间比C组短(P<0.01)。结论内镜治疗能及时解除胆胰管开口的梗阻,通畅胆胰液的引流,微创、安全、有效,是治疗ABP的有效方法。
Objective To evaluate the value of early endoscopic treatment of acute gallstone pancreatitis (ABP). Methods 69 cases of ABP patients, early duodenoscopy in 41 cases (D group), 48 h retrograde cholangiopancreatography, endoscopic sphincterotomy with a basket or stone gravel net basket Lithotomy and endoscopic nasobiliary drainage; the other 28 cases (C group) using conventional therapy. Results The postoperative abdominal pain relieved quickly in group D, and the blood and urine amylase started to decrease in 24 hours. The success rate of treatment was 100%. There was no serious complication associated with endoscopic operation. The hospitalization time was shorter than that of group C (P <0.01). Conclusion Endoscopic treatment can promptly relieve the obstruction of the opening of the bile duct and the pancreatic duct. It is an effective method for the treatment of ABP with the drainage, minimally invasive, safe and effective.