王富华++章杰++朱建臣++龙丹

[摘要] 目的 探究急诊ERCP在急性胆源性胰腺炎（ABP）早期治疗中的应用效果。方法 方便选取该院2014年1月—2016年6月接收90例急性胆源性胰腺炎患者作为研究对象，分为观察组与对照组，每组45例。分别给予急诊ERCP治疗（观察组）与常规保守治疗（对照组），比较两组患者预后指标变化及并发症发生率。 结果 观察组治疗后疼痛缓解时间（2.03±0.18）d及住院时间（10.33±2.05）d缩短，血淀粉酶（61.23±13.08）U/L、谷丙转氨酶（200.36±56.04）U/L及总胆红素（113.58±12.64）μmol/L均降低，效果优于对照组（P<0.05）；两组患者在并发症发生率以及病死率差异无统计学意义（P>0.05）。结論 急诊ERCP可显著提升患者预后，改善患者炎性症状，其应用治疗安全性高，值得临床推广。

[关键词] 急诊；ERCP；急性胆源性胰腺炎

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0045-03

[Abstract] Objective To study the application effect of emergency ERCP in the early treatment of acute biliary pancreatitis. Methods 90 cases of patients with acute biliary pancreatitis admitted and treated in our hospital from January 2014 to June 2016 were conveniently selected and divided into two groups with 45 cases in each， and the observation group and the control group respectively adopted the ERCP treatment and routine conservative treatment， and the prognosis index changes and incidence rate of complications were compared between the two groups. Results After treatment， the pains relief time and length of stay in the observation group were shortened ， which were respectively （2.03±0.18）d and （10.33±2.05）d， and the hemodlastase， glutamic-pyruvic transaminase and total bilirubin decreased and the effect was better than that in the control group[（61.23±13.08）U/L，（200.36 56.14）U/L，（113.58±12.64）μmol/L]（P<0.05）， and three were no obvious differences in the incidence rate of complications and morbidity between the two groups（P>0.05）. Conclusion The emergency ERCP can obviously improve the prognosis of patients and improve the inflammatory symptoms with high treatment safety， which is worth clinical promotion.

[Key words] Emergency； ERCP； Acute biliary pancreatitis

急性胆源性胰腺炎（acute biliary pancreatitis，ABP）是临床常见的急腹症之一，胆囊炎、胆结石、胆道感染、胆道蛔虫等都可导致本病的发生[1]。由于其病情进展迅速，并发症多，很容易发展成为重症胰腺炎。所以尽快治疗ABP的关键就是解除胆道梗阻，减轻胆道压力，充分引流胆汁及胰液[2-3]。内镜逆行性胰胆管造影术近年在临床应用较为广泛，由于ERCP不用开刀，创伤小，手术时间短，并发症较外科手术少，住院时间也大大缩短，深受患者欢迎[4]。在短短几十年中ERCP在临床上取得了巨大的成绩，已经成为当今胰胆疾病重要的治疗手段。该研究方便选取该院2014年1月—2016年6月急性胆源性胰腺炎住院患者90例运用急诊ERCP及保守治疗对照治疗急性胆源性胰腺炎，探讨临床疗效，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院急性胆源性胰腺炎住院患者90例（所有患者均在发病72 h内入院）。……