生大黄浸泡液预防高危患者ERCP术后胰腺炎的前瞻性随机对照研究

发布时间：2019-04-19 19:45

【摘要】：目的:评估生大黄浸泡液预防ERCP术后胰腺炎(PEP)及高淀粉酶血症的疗效。方法:从2012年10月至2013年10月,共有500例高危患者被随机分入生大黄组(250例)和对照组(250例),术后均予常规治疗外,生大黄组于ERCP术后(q3h)服用生大黄浸泡液(统一来源的生大黄每次50g开水泡水10min)至通便为止。两组均检测术后24小时血常规、肝功能等。观察患者术后的症状(如腹痛、腹胀等)及通便时间。结果:两组在患者人口统计特征、病史、ERCP流程、患者相关以及手术相关的高风险因素等方面无明显差异。在250例服用生大黄的患者中有5(2%)例出现了PEP,对照组的250位患者中有19(7.6%)例患者出现PEP,两组间差异有显著性意义(P=0.003);ERCP术后高淀粉酶血症在生大黄组和对照组的发生率分别为5.2%(13/250)和16.8%(42/250),生大黄组明显低于对照组(P0.01)。生大黄组中重度PEP例数明显少于对照组,但无统计学意义(P0.05)。生大黄组的术后腹痛发生率也明显低于对照组(P0.01),但腹痛程度无统计学意义(P0.05)。两组在ERCP术前白细胞、血清总胆红素、谷丙转氨酶水平没有明显差异,术后白细胞、谷丙转氨酶和血清总胆红素水平变化均无显著性意义(P0.05)。结论:生大黄可降低高危患者PEP及高淀粉酶血症的发生率,减轻术后腹痛的发生率。
[Abstract]:Objective: to evaluate the effect of rhubarb soaking solution on prevention of (PEP) and hyperamylemia in patients with post-ERCP pancreatitis. Methods: from October 2012 to October 2013, a total of 500 high-risk patients were randomly divided into the rhubarb group (250 cases) and the control group (250 cases). The rhubarb group was treated with rhubarb soaking solution (50 g boiling water 10min per time) after ERCP (Q 3 h) until defecation. Blood routine and liver function were measured 24 hours after operation in both groups. The postoperative symptoms (such as abdominal pain, abdominal distension, etc.) and the duration of defecation were observed. Results: there was no significant difference in demographic characteristics, history, ERCP process, patient-related and surgical-related high risk factors between the two groups. Among the 250 patients who took rhubarb, 5 (2%) had PEP, control group, 19 (7.6%) patients had PEP, (P < 0.05), and there was a significant difference between the two groups (P < 0.05). The incidence of hyperamylase in rhubarb group and control group after ERCP was 5.2% (13 / 250) and 16.8% (42 / 250), respectively. The incidence of hyperamylase in rhubarb group was significantly lower than that in control group (P0.01). The number of moderate and severe PEP cases in rhubarb group was significantly lower than that in control group, but there was no statistical significance (P0.05). The incidence of postoperative abdominal pain in rhubarb group was significantly lower than that in control group (P0.01), but the degree of abdominal pain had no statistical significance (P0.05). There was no significant difference in the levels of leukocyte, serum total bilirubin and glutamic pyruvic transaminase between the two groups before ERCP, but there was no significant difference in the levels of leucocyte, glutamic pyruvic transaminase and serum total bilirubin after operation (P0.05). Conclusion: rhubarb can reduce the incidence of PEP and hyperamylase in high risk patients and relieve the incidence of postoperative abdominal pain.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R576

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