熊去氧胆酸对合并肝功能损伤的胆总管结石患者行内镜逆行胰胆管造影取石术后肝功能恢复的影响

发布时间：2018-06-07 02:39

本文选题：熊去氧胆酸 + 胆总管结石　；参考：《上海医学》2017年08期

【摘要】：目的探究熊去氧胆酸(UDCA)对合并肝功能损伤的胆总管结石患者行内镜逆行胰胆管造影(ERCP)取石术后肝功能恢复的影响。方法将2011年1月—2013年12月上海交通大学附属第一人民医院收治的胆总管结石合并肝功能损伤并行ERCP取石术的患者随机分为UDCA组(术后予UDCA 250mg口服,3次/d)和对照组,疗程均为2周。比较两组间和组内治疗前后肝功能指标的差异。结果共106例患者成功取尽结石且无严重并发症发生,每组53例。治疗后2周,UDCA组和对照组患者总胆红素、直接胆红素、碱性磷酸酶、γ-谷氨酰转移酶、丙氨酸转氨酶和天冬氨酸转氨酶(AST)指标均显著低于同组治疗前(P值均0.05),UDCA组其他肝功能指标(除AST外)均显著低于对照组治疗后(P值均0.05);对照组术后2周肝功能指标升高者及时加服UDCA治疗4周后肝功能指标均显著低于术前和术后2周(P值均0.05)。结论ERCP取石术后加用UDCA治疗可有效促进胆总管结石合并肝功能损伤患者肝功能的恢复。
[Abstract]:Objective to investigate the effect of ursodeoxycholic acid (UDCA) on the recovery of liver function after endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis complicated with hepatic function injury. Methods from January 2011 to December 2013, patients with choledocholithiasis complicated with liver function injury and ERCP lithotripsy were randomly divided into UDCA group and control group. The course of treatment was 2 weeks. To compare the difference of liver function between the two groups before and after treatment. Results A total of 106 patients (53 cases in each group) successfully removed stones without serious complications. Two weeks after treatment, total bilirubin, direct bilirubin, alkaline phosphatase, 纬 -glutamyl transferase were detected in UDCA group and control group. The indexes of alanine aminotransferase and aspartate aminotransferase were significantly lower than those of the same group before and after treatment (except for AST), and the liver function index of the control group was lower than that of the control group 2 weeks after treatment, and the liver function index of the control group was lower than that of the control group at 2 weeks after treatment, and the other indexes of liver function (except AST) in the same group were significantly lower than those in the control group. The indexes of liver function in patients with elevated standard were significantly lower than those before and 2 weeks after UDCA treatment (P < 0.05). Conclusion ERCP plus UDCA can effectively promote the recovery of liver function in patients with choledocholithiasis complicated with liver function injury.
【作者单位】：上海交通大学附属第一人民医院消化科;同济大学附属东方医院消化科;
【分类号】：R657.42

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