胰管支架预防高危患者逆行胰胆管造影术后胰腺炎

发布时间：2018-08-19 09:45

【摘要】：目的探讨胰管支架置入在预防高危患者经内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)及高淀粉酶血症中的作用。方法回顾性分析2013年1月至2014年12月间我院行ERCP治疗的160例PEP高危患者的临床资料。依据是否置入胰管支架,将其分为胰管支架组82例(放置支架)和对照组78例(未放置支架)。观察患者术后腹痛情况,监测术后3、24h血清淀粉酶水平,比较两组术后PEP、高淀粉酶血症的发生率。结果胰管支架组术后3h和术后24h血清淀粉酶水平分别为(184.89±257.33)U/L和(268.07±344.73)U/L,均低于对照组[分别为(305.35±371.81)U/L和(465.86±639.94)U/L],差异有统计学意义(P0.05)。胰管支架组PEP、高淀粉酶血症发生率[2.4%(2/82)、17.1%(14/82)]低于对照组[11.5%(9/78)、30.8%(24/78)],差异有统计学意义(P0.05)。胰管支架组术后腹痛发生率、腹痛评分[19.5%(16/82)、(1.24±0.58)]均低于对照组[43.6%(34/78)、(1.68±0.97)],差异有统计学意义(P=0.001)。结论胰管支架置入可有效预防高危患者PEP及高淀粉酶血症的发生。
[Abstract]:Objective to investigate the role of stent placement in the prevention of (PEP) and hyperamylase after endoscopic retrograde cholangiopancreatography (ERCP) in high risk patients. Methods the clinical data of 160 patients with high risk of PEP treated with ERCP from January 2013 to December 2014 were analyzed retrospectively. According to whether the pancreatic duct stents were placed, they were divided into two groups: the pancreatic duct stents group (82 cases) and the control group (78 cases (no stents). The postoperative abdominal pain and serum amylase levels were observed and compared between the two groups in the incidence of PEP and hyperamylase. Results the serum amylase levels in the pancreatic duct stent group were (184.89 卤257.33) U / L and (268.07 卤344.73) U / L, respectively, which were significantly lower than those in the control group [(305.35 卤371.81) U / L and (465.86 卤639.94) U / L] (P0.05). The incidence of PEP and hyperamylase in the pancreatic duct stent group [2.4% (2 / 82) or 17.1% (14 / 82)] was lower than that in the control group [11.5% (9 / 78) 30.8% (24 / 78)], the difference was statistically significant (P0.05). The incidence of abdominal pain in the pancreatic duct stent group [19.5% (16 / 82), (1.24 卤0.58)] was significantly lower than that in the control group [43.6% (34 / 78), (1.68 卤0.97)]. Conclusion Stent placement of pancreatic duct can effectively prevent the occurrence of PEP and hyperamylase in high risk patients.
【作者单位】：南京医科大学第二附属医院消化科;
【分类号】：R576

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