【作者】 梅智谋； 时昭红； 吴玉芳； 李轶西； 杨林； 刘嵩； 高晓阳； 周晓黎；

【Author】 Meizhimou;Zhao Wuyufang;Liyixi;Liusong;Gaoxiaoyang;Department of Digestive Medicine,Wuhan No.1,Hospital;

【机构】 武汉市第一医院消化内科；

【摘要】 目的探讨应用奥曲肽(善宁)及术后放置胰管支架对治疗性内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)及高淀粉酶血症的预防治疗效果。方法 2017年2月年至2019年5月我科150例行ERCP治疗的患者随机分为3组,奥曲肽组70例,胰管支架组28例,对照组52例。观察PEP、高淀粉酶血症的发生情况、病情恢复情况。结果 3组患者中PEP总发生率为14.0%(21/150),高淀粉酶血症为37.5%(45/120)。对照组PEP、高淀粉酶血症发生率(25.4%、42.3%)明显高于奥曲肽组(12.7%、22.5%)和胰管支架组(7.3%、10.1%),差异有统计学意义(P <0.05)。胰管支架组PEP、高淀粉酶血症发生率的发生率低于生长抑素组(P <0.05)。术后3h奥曲肽组血清淀粉酶(478±531)U/L、胰管支架组为(515±421)U/L,明显低于对照组(1123±341)U/L,差异有统计学意义(P <0.05);但3组术后24h血清淀粉酶水平无明显差异(P> 0.05)。奥曲肽组及胰管支架组胰腺炎患者腹部症状体征消失时间、白细胞计数降至正常时间、平均住院日均较对照组明显缩短,差异有统计学意义(P <0.05)。结论奥曲肽、胰管支架置入均可有效预防PEP及高淀粉酶血症的发生。更多还原

【Abstract】 Objective To investigate the application of oxotriptide(xanin)and postoperative placement of pancreatic duct stent in the treatment of retrograde pancreatic bile duct.Effect of prevention and treatment of pancreatitis(PEP) and hyperamylase after ERCP. Methods From February 2017 to may 2019, patients with 150 ERCP treatments were randomly divided into three groups, 70 cases of octreotide group, 28 cases of pancreatic stent group and 52 cases of control group. To observe the occurrence and recovery of PEP and hyperamylase. Results The total incidence of PEP was 14.0 %(21/150) and that of hyperamylase was 37.5 %(45/120). The incidence of PEP and hyperamylase in the control group(25.4 %, 42.3 %) was significantly higher than that of the otreotide group(12.7 %, 22.5 %) and the pancreatic stent group(7.3 %, 10.1 %), and the difference was statistically significant(p<0.05). The incidence of PEP and hyperamylase in pancreatic stent group was lower than that of somatostatin group(P<0.05). The serum amylase(478 ± 531) U/Lin the postoperative 3 h otreptide group and(515 ± 421) U/L in the pancreatic stent group were significantly lower than the control group(1123 ± 341) U/L, and the difference was statistically significant(P<0.05); However, there was no significant difference in serum amylase level of 24 h in 3 groups(P>0.05). The difference was statistically significant in patients with abdominal symptoms and signs disappearance time, white blood cell count decreased to normal time, and the average day of hospitalization was significantly shorter than that of the control group(P<0.05). Conclusion Octreotide and pancreatic stent can effectively prevent PEP and hyperamylase.更多还原