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目的 观察内镜早期治疗重症胆源性胰腺炎的临床效果.方法 选取确诊为重症胆源性胰腺炎患者100例作为研究对象,均在发病72 h内接受治疗,将其随机分为2组各50例,其中非手术治疗组采用常规对症内科治疗、胃肠减压、灌肠等治疗;内镜治疗组则在非手术治疗组的基础上进行内镜下治疗.比较2组患者1周内的APACHE-Ⅱ和Balthazar CT评分,同时记录2组器官衰竭情况、并发症发生率和病死率.结果 入院后从第3天开始,内镜治疗组的APACHE-Ⅱ评分明显低于非手术治疗组(P<0.05);并发症明显低于非手术治疗组,差异有统计学意义(P<0.05),非手术组的病死率达24.0%高于内镜治疗组的6.0%,差异有统计学意义(P<0.05).结论 早期内镜治疗与非手术治疗相比可降低重症畸形胆源性胰腺炎的器官衰竭率、并发症发生率及病死率,是治疗急性胆源性合并胆道梗阻的有效方法之一.“,”Objective To observe the clinical value of severe biliary pancreatitis with the adoption of early endoscopic therapy.Methods A total of 100 patients with severe gallstone pancreatitis were selected as the study subjects.All cases were treated within 72 hours after onset.They were randomly divided into two groups,each of 50 cases.Non-surgical treatment group used conventional symptomatic medical treatment,gastrointestinal decompression,enema and other methods,without endoscopic therapy;Based on non-surgical treatment group,endoscopic treatment group were given with endoscopic treatment.The APACHE Ⅱ and Balthazar CT scores were compared between two groups in one week.At the same time,the organ failure,complication rate and mortality of two groups were recorded.Results From the third day after admission treatment,the APACHE Ⅱ score of endoscopic treatment group was significantly lower than that of non-operative group(P<0.05).The score of Balthazar CT in endoscopic treatment group was significantly lower than that in non-surgical group at day 7(P<0.05).The total organ failure rate in endoscopic treatment group was significantly lower than that in non-surgical group(P<0.05).Among the endoscopic treatment group,respiratory failure,cardiovascular failure,renal failure and central nervous system failure rate were lower than those in non-surgical group(P<0.05).The total complication of endoscopic treatment group was significantly lower than that of non-surgical group(P<0.05).The mortality rate of non-operation group was 24.0% higher than 6.0% of endoscopic treatment group(P<0.05).Conclusion Compared with non-operative treatment,the early endoscopic treatment can reduce the incidence of the complication and death of severe biliary pancreatitis,which is one of the effective methods for treatment of acute biliary obstruction combined with biliary tract obstruction.