朴光熙　金红旭

[摘要] 目的 探讨急诊ERCP 治疗急性胆源性胰腺炎的疗效。 方法 选取2016年1月～2018年1月在我院收治的急性胆源性胰腺炎患者200例，将患者随机分为观察组和对照组，各100例，对照组采取常规保守治疗，观察组采取急诊ERCP 治疗，比较两组患者治疗后的疗效。 结果 观察组患者治疗后的疗效优于对照组（P<0.05）。观察组患者的AMYL水平治疗后明显低于对照组（P<0.05）。 结论 急诊ERCP 治疗急性胆源性胰腺炎可以显著提高临床疗效，降低淀粉酶水平，减轻患者的临床症状，缩短住院时间。

[关键词] 急性胆源性胰腺炎；急诊；ERCP；AMYL水平

[中图分类号] R378.2 [文献标识码] B [文章编号] 1673-9701（2018）20-0099-02

Clinical observation of 200 cases of acute biliary pancreatitis treated by emergency ERCP

PIAO Guangxi JIN Hongxu

Department of Emergency Medicine， the General Hospital of Shenyang Military， Shenyang 110016， China

[Abstract] Objective To investigate the efficacy of emergency ERCP in the treatment of acute gallstone pancreatitis. Methods 200 patients with acute gallstone pancreatitis who were treated in our hospital from January 2016 to January 2018 were selected. Participants were randomly divided into observation group and control group with 100 cases each. The control group was treated with conventional conservative treatment. The observation group was treated with emergency ERCP. The curative effect and time of abdominal pain relief， gastrointestinal function recovery time and average length of hospitalization were compared between the two groups. The AMYL levels before and after treatment were also compared between the two groups. Results The curative effect of the observation group after treatment was better than that of the control group（P<0.05）. The AMYL level of the observation group was significantly lower than that of the control group after treatment（P<0.05）. Conclusion Emergency ERCP treatment of acute gallstone pancreatitis can significantly improve clinical efficacy， reduce amylase levels， reduce clinical symptoms， and shorten duration of hospitalization.

[Key words] Acute gallstone pancreatitis； Emergency； ERCP； AMYL level

急性膽源性胰腺炎（acute biliary pancreatitis，ABP）是临床常见的急腹症之一，病情进展快，并发症多，部分患者很快进展为重症胰腺炎[1]。尽快解除梗阻，减轻胆道压力，充分引流胆汁及胰液，是ABP治疗的关键[2]。急诊ERCP在临床上又被称为经内镜逆行性胰胆管造影，主要用于治疗胆囊疾病及胰腺疾病等[3]。2016年1月～2018年1月，我院急诊ERCP治疗急性胆源性胰腺炎200例，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年1月～2018年1月在我院收治的急性胆源性胰腺炎患者200例，ABP诊断符合急性胰腺炎的诊断[4]，除外其他原因引起的胰腺炎，如暴饮暴食等，除外梗阻性急性胰腺炎及合并严重心肝肾等重要脏器功能障碍者、血液系统疾病者。其中男110例，女90例，年龄36～72岁，平均（50.8±6.4）岁，其中合并胆囊结石19例，胆囊切除术后30例；胰腺发育不全2例，腹腔感染2例，脾切除术后1例。将200例急性胆源性胰腺炎患者随机分为两组，各100例，两组组间比较，差异无统计学意义（P>0.05），具有可比性。

1.2 治疗方法

两组患者入院后均给予常规保守治疗，观察组患者在保守治疗基础上急诊行内镜逆行胰胆造影（ERCP）。……