吲哚美辛及鼻胆管引流预防内镜下逆行胰胆管造影术后胰腺炎及高淀粉酶血症效果观察

发布时间：2018-07-13 14:22

【摘要】：目的探讨预防性吲哚美辛直肠给药及术后鼻胆管引流术(ENBD)对内镜下逆行胰胆管造影(ERCP)术后胰腺炎(PEP)及高淀粉血症的预防作用及安全性。方法行ERCP诊治的患者152例,随机分为吲哚美辛组(n=49)、ENBD组(n=50)和安慰剂组(n=53)。观察各组术后2、6、24 h血清淀粉酶水平,对比PEP、高淀粉酶血症的发生率及预后。结果吲哚美辛组与ENBD组的PEP及高淀粉酶血症的发生率低于安慰剂组(P均0.05)。血清淀粉酶变化,吲哚美辛组和ENBD组术后2、6 h较安慰剂组低(P均0.05);但术后24 h血清淀粉酶水平组间比较差异无统计学意义(P均0.05)。吲哚美辛组和ENBD组胰腺炎患者腹部症状体征消失时间及平均住院时间较安慰剂组明显缩短(P均0.05)。结论吲哚美辛、ENBD均可有效预防ERCP术后PEP及高淀粉酶血症的发生,同时吲哚美辛干预方法更为经济。
[Abstract]:Objective to investigate the preventive effect and safety of prophylaxis of indomethacin for rectal administration and postoperative nasobiliary drainage (ENBD) in patients with pancreatitis (PEP) and hyperamyloidemia after endoscopic retrograde cholangiopancreatography (ERCP). Methods 152 patients treated with ERCP were randomly divided into two groups: indomethacin group (n = 49) and placebo group (n = 53). The levels of serum amylase were observed at 24 hours after operation, and the incidence and prognosis of PEP and hyperamylase were compared. Results the incidence of PEP and hyperamylase in indomethacin group and ENBD group was lower than that in placebo group (P 0.05). The changes of serum amylase in indomethacin group and ENBD group were lower than those in placebo group at 2 h after operation (P 0.05), but there was no significant difference in serum amylase level at 24 h after operation (all P 0.05). In indomethacin group and ENBD group, the time of disappearance of abdominal symptoms and signs and the average hospitalization time were significantly shorter than those in placebo group (P 0.05). Conclusion Indomethacin ENBD can effectively prevent PEP and hyperamylase after ERCP, and the intervention of indomethacin is more economical.
【作者单位】：南京鼓楼医院集团宿迁市人民医院;
【分类号】：R576

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