60例胆源性急性胰腺炎早期非手术治疗分析
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摘要
目的研究分析早期非手术和急诊手术治疗胆源性急性胰腺炎的临床疗效及安全性。方法选取2016年1月1日-2018年7月1日期间收治的60例胆源性急性胰腺炎早期患者,依据抽签法分为观察组(n=30,早期非手术治疗)与对照组(n=30,急诊手术治疗),对2组患者的临床疗效进行比较。结果观察组轻症梗阻型10例,其中1例72小时内中转手术;重症非梗阻型4例,36小时内转急诊手术治疗1例;重症梗阻型5例,36小时内转手术治疗1例。观察组患者住院天数少于对照组,差异有统计学意义;出院时观察组AMY低于对照组,但差异无统计学意义;观察组患者并发症发生率6.67%,低于对照组26.67%,差异有统计学意义;观察组治疗总有效率100.0%,高于对照组86. 7%,无死亡患者,对照组死亡率10.0%,组间差异显著。结论胆源性急性胰腺炎早期非手术治疗具有可行性,且治疗效果比较理想,可显著降低患者死亡率,安全性高,有助于患者康复,具有临床推广价值。
Objective To analyze the clinical efficacy and safety of early non-surgical and emergency surgery for biliary acute pancreatitis. Methods 60 patients with early stage biliary acute pancreatitis admitted from January 1 st,2016 to July 1 st,2018 were enrolled. According to the drawing method, the observation group(n=30, early non-surgical treatment) and the control group(n=30, emergency surgery) were compared, and the clinical effects of the two groups were compared. Results Ten cases of mild obstruction in the observation group, including 1 case of transposition within 72 hours; 4 cases of severe non-obstruction type, 1 case of emergency operation within 36 hours,5 cases of severe obstruction, and 1 case of operation within 36 hours;The number of hospital stays in the observation group was lower than that in the control group, the difference was statistically significant. The AMY of the observation group was lower than that of the control group at the time of discharge, but the difference was not statistically significant. The incidence of complications in the observation group was observed 6. 67% was lower than the control group 26. 67%, the difference was statistically significant; the total effective rate of the observation group was 100. 0% higher than the control group 86. 7%, no death patients, control group The mortality rate was 10. 0%,and the difference between the groups was significant. Conclusions The early non-surgical treatment of biliary acute pancreatitis was feasible, and the treatment effect was ideal. It could significantly reduce the mortality of patients,high safety, and help patients recover. It has clinical promotion value.
Objective To analyze the clinical efficacy and safety of early non-surgical and emergency surgery for biliary acute pancreatitis. Methods 60 patients with early stage biliary acute pancreatitis admitted from January 1 st,2016 to July 1 st,2018 were enrolled. According to the drawing method, the observation group(n=30, early non-surgical treatment) and the control group(n=30, emergency surgery) were compared, and the clinical effects of the two groups were compared. Results Ten cases of mild obstruction in the observation group, including 1 case of transposition within 72 hours; 4 cases of severe non-obstruction type, 1 case of emergency operation within 36 hours,5 cases of severe obstruction, and 1 case of operation within 36 hours;The number of hospital stays in the observation group was lower than that in the control group, the difference was statistically significant. The AMY of the observation group was lower than that of the control group at the time of discharge, but the difference was not statistically significant. The incidence of complications in the observation group was observed 6. 67% was lower than the control group 26. 67%, the difference was statistically significant; the total effective rate of the observation group was 100. 0% higher than the control group 86. 7%, no death patients, control group The mortality rate was 10. 0%,and the difference between the groups was significant. Conclusions The early non-surgical treatment of biliary acute pancreatitis was feasible, and the treatment effect was ideal. It could significantly reduce the mortality of patients,high safety, and help patients recover. It has clinical promotion value.
引文
[1]刘成斌,张淋淞.急性胆源性胰腺炎208例诊治体会[J].内蒙古中医药,2014, 33(11):19.
[2]王铁维.胆源性急性胰腺炎的临床诊治体会[J].中国初级卫生保健,2016, 30(3):92-93.
[3] Portelli M, Jones C D. Severe acute pancreatitis:pathogenesis,diagnosis and surgical management[J]. Hepatobiliary&Pancreatic Diseases International, 2017, 16(2):155-159.
[4]贾会文,赵永刚,张磊,等.生长抑素对老年胆源性急性胰腺炎患者C反应蛋白、内皮素-1及肿瘤坏死因子α的影响[J].中国老年学杂志,2015, 35(13):3686-3687.
[5]张声生,李乾构,李慧臻,等.急性胰腺炎中医诊疗专家共识意见[J].中华中医药杂志,2013, 28(6):1826-1831.
[6]张冬磊,郝建宇,杨宁.胆源性急性胰腺炎患者甲状腺激素水平变化及意义[J].中华实用诊断与治疗杂志,2015,29(12):1226-1228.
[7]仲育娇.胆源性急性胰腺炎56例临床分析[J].航空航天医学杂志,2017, 28(3):316-317.
[8]汪少卫.血脂异常性急性胰腺炎与胆源性急性胰腺炎患者临床特点的比较研究[J].当代医药论丛,2018, 16(7):105-106.
[9]崔云峰.胆源性急性胰腺炎的诊治[J].中国普外基础与临床杂志,2015, 22(1):8-10.
[10]廖晓强.胆源性急性胰腺炎采用手术方案治疗临床体会[J].大家健康(学术版),2014, 8(23):107.
[11]方金满,潘文,张建敏,等.高脂血症性急性胰腺炎的临床特征分析[J].中国医药科学,2014, 4(14):235-238.
[12]何良和,孙建华,查名辉,等.52例胆源性急性胰腺炎的临床治疗体会[J].当代医药论丛,2014, 12(11):251.
[13]马红梅,戴丐国,连建安,等.生长抑素联合参附注射液治疗胆源性急性胰腺炎的临床观察[J].中国药房,2014,25(4):343-345.
[14]李建龙.胆源性急性胰腺炎的手术指征与时机选择[J].基层医学论坛,2014, 18(2):209-210.
[15]刘圆圆,江迈红,戴光荣.高脂血症性急性胰腺炎和胆源性急性胰腺炎临床特征分析[J].山西医科大学学报,2013, 44(12):976-979.
[16]魏小兵,连丽云.胆源性急性胰腺炎的临床诊治体会[J].当代医学,2013, 19(35):98-99.
[17]李晓东,翁皖,秦学潜,等.高脂血症性与胆源性急性胰腺炎的临床对比分析[J].现代生物医学进展,2013,13(28):5564-5566, 5570.
[18]蒋成佳,王小峰.110例胆源性急性胰腺炎临床治疗分析[J].当代医学,2013, 19(28):42.
[19]李荣霞.高脂血症性急性胰腺炎对比胆源性急性胰腺炎临床特征分析[J].青海医药杂志,2013, 43(6):4-6.
[20]李凤旭.35例胆源性急性胰腺炎的早期治疗探讨[J].中国医药指南,2013, 11(15):540-541.
[21]陈利辉,刘向军.手术治疗胆源性急性胰腺炎的预后效果[J].中外医学研究,2013, 11(9):111.
[22]粟艳林.胆源性急性胰腺炎早期治疗方式的探讨[J].中国民族民间医药,2013, 22(1):24.
[2]王铁维.胆源性急性胰腺炎的临床诊治体会[J].中国初级卫生保健,2016, 30(3):92-93.
[3] Portelli M, Jones C D. Severe acute pancreatitis:pathogenesis,diagnosis and surgical management[J]. Hepatobiliary&Pancreatic Diseases International, 2017, 16(2):155-159.
[4]贾会文,赵永刚,张磊,等.生长抑素对老年胆源性急性胰腺炎患者C反应蛋白、内皮素-1及肿瘤坏死因子α的影响[J].中国老年学杂志,2015, 35(13):3686-3687.
[5]张声生,李乾构,李慧臻,等.急性胰腺炎中医诊疗专家共识意见[J].中华中医药杂志,2013, 28(6):1826-1831.
[6]张冬磊,郝建宇,杨宁.胆源性急性胰腺炎患者甲状腺激素水平变化及意义[J].中华实用诊断与治疗杂志,2015,29(12):1226-1228.
[7]仲育娇.胆源性急性胰腺炎56例临床分析[J].航空航天医学杂志,2017, 28(3):316-317.
[8]汪少卫.血脂异常性急性胰腺炎与胆源性急性胰腺炎患者临床特点的比较研究[J].当代医药论丛,2018, 16(7):105-106.
[9]崔云峰.胆源性急性胰腺炎的诊治[J].中国普外基础与临床杂志,2015, 22(1):8-10.
[10]廖晓强.胆源性急性胰腺炎采用手术方案治疗临床体会[J].大家健康(学术版),2014, 8(23):107.
[11]方金满,潘文,张建敏,等.高脂血症性急性胰腺炎的临床特征分析[J].中国医药科学,2014, 4(14):235-238.
[12]何良和,孙建华,查名辉,等.52例胆源性急性胰腺炎的临床治疗体会[J].当代医药论丛,2014, 12(11):251.
[13]马红梅,戴丐国,连建安,等.生长抑素联合参附注射液治疗胆源性急性胰腺炎的临床观察[J].中国药房,2014,25(4):343-345.
[14]李建龙.胆源性急性胰腺炎的手术指征与时机选择[J].基层医学论坛,2014, 18(2):209-210.
[15]刘圆圆,江迈红,戴光荣.高脂血症性急性胰腺炎和胆源性急性胰腺炎临床特征分析[J].山西医科大学学报,2013, 44(12):976-979.
[16]魏小兵,连丽云.胆源性急性胰腺炎的临床诊治体会[J].当代医学,2013, 19(35):98-99.
[17]李晓东,翁皖,秦学潜,等.高脂血症性与胆源性急性胰腺炎的临床对比分析[J].现代生物医学进展,2013,13(28):5564-5566, 5570.
[18]蒋成佳,王小峰.110例胆源性急性胰腺炎临床治疗分析[J].当代医学,2013, 19(28):42.
[19]李荣霞.高脂血症性急性胰腺炎对比胆源性急性胰腺炎临床特征分析[J].青海医药杂志,2013, 43(6):4-6.
[20]李凤旭.35例胆源性急性胰腺炎的早期治疗探讨[J].中国医药指南,2013, 11(15):540-541.
[21]陈利辉,刘向军.手术治疗胆源性急性胰腺炎的预后效果[J].中外医学研究,2013, 11(9):111.
[22]粟艳林.胆源性急性胰腺炎早期治疗方式的探讨[J].中国民族民间医药,2013, 22(1):24.