摘要
目的 探讨内镜治疗慢性阻塞性胰腺炎疗效及并发症。方法 经内镜治疗 29例慢性胰腺炎中胰管括约肌切开术 27例 (19例为内镜治疗前处置 )，副乳头切开 8例，乳头括约肌切开术 5例，网篮取胰石 9例，胰管内引流 7例，鼻胰管引流 3例，辅助探条或球囊扩张共 14例。 13例治疗前、后检测胰腺内分泌功能。结果 29例中 26例（ 89.7％）治疗后腹痛消失或明显减轻， 9例胰腺结石患者中 6例取出胰石； 7例胰管内引流第 6周末拔管，引流管未阻塞。治疗后复查口服法糖耐量试验和免疫反应性胰岛素， 6例糖代谢异常中 1例境界型转为正常型， 1例糖尿病型转为境界型。本组有 2例并发急性胰腺炎， 1例胰液感染。 18例随访 1年半， 3例腹痛再发。结论 内镜治疗慢性胰腺炎是一种较安全、有效的方法。
Objective The efficacy of endoscopic treatment for chronic pancreatitis was studied. Methods 29 patients with chronic pancreatitis, received the therapy of endoscopy. Of the series 27 had endoscopic pancreatic sphincterotomy (EPST)， as a preceding treatment in 19 cases, 8 had minor papillotomy, 6 subjected to endoscopic sphincterotomy (EST). Pancreatic stones were extracted with basket (n=9) and duct dilated with balloon or bougienage (n=14) followed by pancreatic duct endoprothesis (PDE, n=7) and nasal pancreatic drainage (NPD, n=3). Pancreatic functions were tested before and after therapy (n=13). Results Abdominal pain was eliminated or redcuced obviously in 26/29 (89.7％ ) cases. Pancreatic stone was extracted successfully in 6/9 cases, no occlusion detected in 7 instances having PDE at the end of 6 weeks when the prothesis was withdrawn. In 6 cases with abnormal glucose metabolism reexanmined with oral gluose tolerance test (75g O－ GTT) and immunoreactive insulin (IRI) test, it was found that one patient turned to normal type from boardline type and one turned to boardline type from the abnormal. Acute panceratitis ensued in 2 cases, infection of pancreatic fluid occured in 1. Abdominal pain recurred in 3 out of 18 followed up for one and half years. Conclusion Endoscopic management for chronic pancreatitis is relatively effective and secure.
出处
《中华消化内镜杂志》
2000年第5期271-273,共3页
Chinese Journal of Digestive Endoscopy
基金
黑龙江省杰出青年科学基金
