加贝酯不同时期应用预防ERCP术后高淀粉酶血症及胰腺炎的研究

发布时间：2018-07-05 04:10

本文选题：加贝酯 + ERCP　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：观察加贝酯在不同时期应用对预防ERCP术后高淀粉酶血症及ERCP术后胰腺炎的疗效。方法：将381例行ERCP的胆胰疾病患者根据加贝酯的不同应用时期分为四组，，分别为术前组（88例）、术后组（97例）、完全组（101例）及对照组（95例）。术前组、术后组及完全组均为用药组，术前组在ERCP术前6小时内予以加贝酯600毫克+0.9%NaCL注射液500毫升静脉滴注；术后组在术后12小时内予以加贝酯600毫克+0.9%NaCL注射液500毫升静脉滴注；完全组在ERCP术前6小时开始予以加贝酯600毫克+0.9%NaCL注射液500毫升静脉滴注，并于术后12小时内再予以加贝酯600毫克+0.9%NaCL注射液500毫升静脉滴注，对照组仅予以静脉滴注0.9%NaCL注射液500毫升。ERCP术后24小时，测血清淀粉酶，同时观察有无持续腹痛、发热、呕吐等表现。结果：术后24小时血清淀粉酶水平：各用药组较对照组显著降低（P0.05）；ERCP术前组、术后组、完全组及对照组，术后高淀粉酶血症的发生率分别为28.41%、26.80%、15.84%、46.32%，急性胰腺炎的发生率分别为3.41%、3.09%、1.98%、9.47%，用药组各组术后高淀粉酶血症及胰腺炎发生率较对照组显著降低，差异有统计学意义（P0.05）；完全组术后24小时血清淀粉酶水平及高淀粉酶血症发生率均显著低于术前组、术后组，差异有统计学意义（P0.05），但三组间术后胰腺炎发生率无显著差异（P0.05）。结论：甲磺酸加贝酯能有效降低ERCP术后血清淀粉酶水平，能够预防术后高淀粉酶血症及术后胰腺炎的发生；推荐加贝酯的应用方式为，ERCP术前6小时600毫克静脉滴注，术后12小时内600毫克静脉滴注。
[Abstract]:Aim: to observe the effect of Gabexin in preventing hyperamylase and pancreatitis after ERCP. Methods: 381 patients with cholangiopancreatic diseases were divided into four groups according to different periods of application of Gabexate: preoperative group (88 cases), postoperative group (97 cases), complete group (101 cases) and control group (95 cases). The preoperative group, the postoperative group and the complete group were all treated with drugs. The preoperative group was given 600 mg of gabel 600 mg and 500 ml intravenous drip of 0.9 NaCL injection within 6 hours before ERCP. Within 12 hours after the operation, the patients in the postoperative group were given 600 mg of gabelate 600 mg and 500 ml intravenous drip of 0.9 NaCL injection, and the complete group received 600 mg 0.9 NaCL injection 500 ml intravenous drip beginning 6 hours before ERCP. Within 12 hours after operation, the patients in the control group were given 500 ml intravenous drip of 0.9NaCL injection with 600 mg Gabecyl ester, while the control group was only given 500 ml of 0.9 NaCL injection. The serum amylase was measured 24 hours after the operation, and the continuous abdominal pain and fever were observed. Vomiting, etc Results: 24 hours after operation, the serum amylase levels in each medication group were significantly lower than those in the control group (P0.05), the preoperative group, the postoperative group, the complete group and the control group were significantly lower than those in the control group. The incidence of postoperative hyperamylase and acute pancreatitis were 28.41, 26.80 and 46.32, respectively. The incidence of acute pancreatitis was 3.41 and 3.090.98 respectively. The incidence of hyperamylase and pancreatitis in the treatment group was significantly lower than that in the control group (P0.05). The levels of serum amylase and the incidence of hyperamylase in the complete group 24 hours after operation were significantly lower than those in the preoperative group (P0.05), but there was no significant difference in the incidence of postoperative pancreatitis among the three groups (P0.05). Conclusion: Gabecyl mesylate can effectively reduce the level of serum amylase after ERCP and prevent the occurrence of postoperative hyperamylase and postoperative pancreatitis. 600 mg intravenous drip was given within 12 hours after operation.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R576

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