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内镜与手术的经验作为慢性胰腺炎的初始管理
U Lara-Orozco1, V Ortiz-Higareda1, J L Martínez-Ordaz1
1Servicio de Gastrocirugía, Hospital de Especialidades Dr. Bernardo Sepúlveda Gutiérrez, UMAE Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
Revista de gastroenterologia de Mexico (English)
|October 1, 2024
概括
慢性胰腺炎的手术治疗提供了比内镜治疗更好的疼痛缓解. 超过一半的患者最初接受了内镜治疗,最终需要手术,突出了对个性化护理的需要.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 胰腺疾病 胰腺疾病
背景情况:
- 慢性胰腺炎是一种复杂的纤维炎性胰腺综合征.
- 治疗包括医疗,内镜和手术方法.
- 根据初始管理,了解疾病进展至关重要.
研究的目的:
- 为了比较慢性胰腺炎患者的进展,最初通过内镜治疗治疗,而不是手术干预.
- 评估与疼痛,干预和长期管理相关的结果.
主要方法:
- 对22名慢性胰腺炎患者 (2015-2021) 的回顾性,观察性,纵向性研究.
- 纳入标准:慢性胰腺炎的诊断和通过内镜或手术的初始治疗.
- 收集有关干预,疼痛缓解,药物使用和临床结果的数据.
主要成果:
- 手术管理组 (10名患者) 的干预次数 (1.1) 比内镜组 (12名患者,3次干预;p=0.001) 的干预次数少.
- 在手术组,疼痛缓解显著改善 (p=0.035).
- 58.3%的患者最初接受了内镜治疗,最终需要手术;在糖尿病或死亡率等其他结果中没有显著差异.
结论:
- 疼痛是慢性胰腺炎侵袭性治疗的主要驱动因素.
- 很大一部分最初接受内镜治疗的患者需要随后的手术.
- 多学科和个性化治疗决策对于治疗慢性胰腺炎至关重要.
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