渐进改变支架数量治疗儿童及青少年慢性胰腺炎临床疗效分析

Effects of pancreatic stent number on the management of recurrent chronic pancreatitis in children and adolescents

摘要:

目的 探讨改变内镜放置胰管支架的数量，对改善ERCP治疗儿童及青少年慢性胰腺炎疗效的影响。方法 对3～16岁行两次及以上ERCP治疗的慢性胰腺炎患者，按照第2次行ERCP是否基于前次基础改变支架数量分为对照组以及渐变组，比较每组患儿在每一段随访期间内因腹痛入院的次数以及因慢性胰腺炎需要入院和进行手术治疗的百分比，以此判断改变胰管支架数量对慢性胰腺炎患儿的治疗效果。结果 共纳入3～16岁行至少两次ERCP诊治慢性胰腺炎患者11例，对照组（5例）和渐变组（6例）需要住院患儿的例数百分比［7例次（140.0％）比2例次（33.3％）］以及患儿因腹痛而入院的平均次数［1.5次比0.8次］，差异均有统计学意义（P均＜0.001）。因为腹痛而入院治疗的概率在两组间差异也有统计学意义（P=0.003）。结论 第2次就诊时增加胰管支架数量治疗慢性胰腺炎可减少因腹痛而导致的再入院治疗次数。

Abstract:

Objective To investigate the effects of changing the pancreatic stent number based on the last procedure on the prognosis of children and adolescents with recurrent chronic pancreatitis. Methods Data of 11 pediatric patients （3-16 years old） with chronic pancreatitis， undergoing ERCP for at least twice were retrospectively analyzed. Based on whether the number of stents changed in the second procedure， patients were divided into the control group（more than once and no change in the number），and the changing group（more than once and change in the stent number in the second procedure）. The hospitalization and surgery percentage and number of hospitalizations due to abdominal pain in follow-up period were compared to study whether number change of stents was efficient to cure pediatric patients with chronic pancreatitis. Results Eleven pediatric patients undergoing at least 2 ERCP procedures were recruited into our group. The hospitalization percentages were 140％（n=7） and 33.3％（n=2） in the control group（n=5） and the changing group （n=6） respectively（P＜0.001）. The number of hospitalizations due to abdominal pain was 1.5 and 0.8 in the control group and the changing group respectively （P＜0.001）. The percentage of patient hospitalizations due to abdominal pain significantly reduced in the changing group （P=0.003）. Conclusion Increase in pancreatic stent number in the second procedure in pediatric patients can decrease hospital admissions related to the pancreatitis.