内镜术联合腹腔镜灌洗治疗急性重症胰腺炎的临床研究

摘要

目的:研究内镜术联合腹腔镜灌洗治疗急性重症胰腺炎的临床疗效.方法:选择2013年4月至2016年10月于我院治疗诊断为SAP 的患者154例,随机分为观察组和对照组各77例,对照组采用常规综合治疗+经内镜逆行性胰胆管造影术治疗,在此基础上,观察组予腹腔镜灌洗治疗,观察两组疗效、症状、体征、生化指标改善及术后并发症情况.结果:两组患者术后疗效无显著差异,但观察组腹部症状改善时间、体温恢复时间、血淀粉酶恢复时间及肛门排气时间均较对照组快,两组患者 TNF-α、IL-6、IL-8明显改善,观察组患者并发症发生率低于对照组(P<0.05或0.01).结论:采用内镜联合腹腔灌洗手术治疗急性重症胰腺炎疗效肯定,可减少患者临床症状持续时间,明显改善临床血生化指标,减少手术并发症发生率.%Objective:To study the clinical efficacy of endoscopic surgery combined with laparoscopic lavage in the treatment of severe acute pancreatitis.Methods:154 patients were randomly divided into observa-tion group and control group. The control group was treated with routine comprehensive therapy + endoscopic retrograde cholangio-pancreatography. On the basis of this,the observation group was given laparoscopic lav-age treatment.The efficacy,symptoms,signs,biochemical indicators and postoperative complications were ob-served in the two groups. Results:There was no significant difference in the curative effect between the two groups. However,the recovery time of abdominal symptoms,body temperature,amylase and the time of anal exhaust were faster than those in the control group. The levels of TNF-α, IL- IL-8 were significantly im-proved,the incidence of complications in the observation group was lower than that in the control group(P <0.05 or 0.01).Conclusion:Endoscopic combined with intraperitoneal lavage is effective in the treatment of se-vere acute pancreatitis,which can reduce the duration of clinical symptoms and improve the clinical blood bio-chemical indexes and reduce the incidence of surgical complications.