【作者】 张静；

【导师】 谢友红；

【作者基本信息】 重庆医科大学 ， 内科学， 2015， 硕士

【摘要】 目的：探讨经内镜鼻胰管引流(endoscopic nasopancreatic drainage, ENPD)治疗急性胰腺炎(Acute Pancreatitis, AP)巨大假性囊肿的安全性及有效性。方法：将2010年6月～2013年12月重庆医科大学附属第一医院57例AP伴胰腺巨大假性囊肿的患者纳入研究,分为两个治疗组,其中29例患者在保守治疗的基础上接受ENPD治疗(ENPD治疗组)；28例患者接受保守治疗,即对照组。回顾性分析两组患者在不同治疗方案下的治疗效果及并发症情况。结果：ENPD治疗组中,有2例患者因不能耐受鼻胰管分别于引流2天、5天后改用经皮穿刺引流。ENPD治疗组腹痛缓解时间、住院天数、体温及白细胞恢复正常的时间均短于保守治疗组,手术率、死亡率低于对照组,差异均有统计学意义(P<0.05)。引流过程中有3例患者发生感染,但未出现胃肠道出血及穿孔等并发症,且引流完全(CT下未见胰腺假性囊肿)。结论：ENPD能有效减轻胰管压力,控制胰腺炎进展,减少并发症的发生,对于治疗胰腺巨大假性囊肿是安全有效的。更多还原

【Abstract】 Object:To assess efficacy and safety of endoscopic naso-pancreatic drainage (ENPD) for acute fluid collections at acute pancreatitis with large pseudocyst.Methods:A total of 57 acute pancreatitis(AP) patients with large pancreatic admitted from June 2010 to december 2013 at The First Affiliated Hospital of Chongqing Medical University were enrolled in this study, of them 29 patients received conservative therapy combined with ENPD (ENPD group) and 28 patients received conservative therapy (conservative group or marched group).The therapeutic efficacies and complications of the two groups were analyzed retrospectively.Result:In ENPD group, two patients couldn’t stand the discomfort to change to the other therapy of the percutaneous catheter drainage (PCD) for 2 days,5 days later. The relief of abdominal pain, duration of hospitalization, normalization of body temperature and white blood cell were faster or shorter(P<0.05) in ENPD group than in conservative therapy group. Surgical operation rate and morality were lower in ENPD group than in conservative therapy group. Three patients infection occurred during ENPD procedure, but no perforation and bleeding occurred and drainage is complete (The pseudocyst was not seen under CT).Conclusions:ENPD not only can be used to reduce the occurrence of complications, but also to reduce the pressure of the pancreatic duct to control the development of pancreatitis.更多还原