中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2009年
4期
232-234
,共3页
高夕英%张晓妮%毕玉峰%孙明水
高夕英%張曉妮%畢玉峰%孫明水
고석영%장효니%필옥봉%손명수
胰腺管造影术,内窥镜逆行%胰腺炎%药物预防
胰腺管造影術,內窺鏡逆行%胰腺炎%藥物預防
이선관조영술,내규경역행%이선염%약물예방
Cholangiopancreatography,endoscopic retrograde%Pancreatitis%Chemoprophylaxis
目的 探讨质子泵抑制剂(奥美拉唑)预防诊疗性ERCP术后急性胰腺炎(AP)及高淀粉酶血症的临床效果.方法 250例ERCP操作成功的病例按数字表法随机分成对照组(126例)和治疗组(124例).在ERCP术后立即给予奥曲肽的基础上,治疗组给予静脉注射40 mg奥美拉唑注射液,12 h重复注射一次,对照组给予同等体积生理盐水.检测两组术后4、24 h血清淀粉酶及TNF-α的含量,观察术后胰腺炎的发生率.结果 两组患者在年龄、性别、ERCP操作时间和治疗性操作比例上均无显著统计学差异.治疗组术后4、24 h血清淀粉酶及TNF-α含量分别为(221±31)U/L、(181±39)U/L、(0.264±0.052)ng/ml和(0.257±0.071)ng/ml,显著低于对照组的(272±32)U/L、(227±30)U/L、(0.372±0.047)ng/ml和(0.422±0.026)ng/ml(P<0.05).治疗组胰腺炎发病率为1.6%,显著低于对照组的6.5%(P=0.04).结论 联合应用奥美拉唑和奥曲肽可以更有效地预防ERCP术后高淀粉酶血症和AP的发生.
目的 探討質子泵抑製劑(奧美拉唑)預防診療性ERCP術後急性胰腺炎(AP)及高澱粉酶血癥的臨床效果.方法 250例ERCP操作成功的病例按數字錶法隨機分成對照組(126例)和治療組(124例).在ERCP術後立即給予奧麯肽的基礎上,治療組給予靜脈註射40 mg奧美拉唑註射液,12 h重複註射一次,對照組給予同等體積生理鹽水.檢測兩組術後4、24 h血清澱粉酶及TNF-α的含量,觀察術後胰腺炎的髮生率.結果 兩組患者在年齡、性彆、ERCP操作時間和治療性操作比例上均無顯著統計學差異.治療組術後4、24 h血清澱粉酶及TNF-α含量分彆為(221±31)U/L、(181±39)U/L、(0.264±0.052)ng/ml和(0.257±0.071)ng/ml,顯著低于對照組的(272±32)U/L、(227±30)U/L、(0.372±0.047)ng/ml和(0.422±0.026)ng/ml(P<0.05).治療組胰腺炎髮病率為1.6%,顯著低于對照組的6.5%(P=0.04).結論 聯閤應用奧美拉唑和奧麯肽可以更有效地預防ERCP術後高澱粉酶血癥和AP的髮生.
목적 탐토질자빙억제제(오미랍서)예방진료성ERCP술후급성이선염(AP)급고정분매혈증적림상효과.방법 250례ERCP조작성공적병례안수자표법수궤분성대조조(126례)화치료조(124례).재ERCP술후립즉급여오곡태적기출상,치료조급여정맥주사40 mg오미랍서주사액,12 h중복주사일차,대조조급여동등체적생리염수.검측량조술후4、24 h혈청정분매급TNF-α적함량,관찰술후이선염적발생솔.결과 량조환자재년령、성별、ERCP조작시간화치료성조작비례상균무현저통계학차이.치료조술후4、24 h혈청정분매급TNF-α함량분별위(221±31)U/L、(181±39)U/L、(0.264±0.052)ng/ml화(0.257±0.071)ng/ml,현저저우대조조적(272±32)U/L、(227±30)U/L、(0.372±0.047)ng/ml화(0.422±0.026)ng/ml(P<0.05).치료조이선염발병솔위1.6%,현저저우대조조적6.5%(P=0.04).결론 연합응용오미랍서화오곡태가이경유효지예방ERCP술후고정분매혈증화AP적발생.
Objective To assess the efficacy of proton pump inhibitors for preventing post-endoscopio retrograde cholangiopancreatography (post-ERCP) pancreatitis and hyperamylasemia. Methods A total of 250 patients, who underwent successful ERCP, were randomized into control group (n = 126) or treatment group (n=124) after ERCP. All patients received octreotide, the patients in treatment group received omeprazole 40 mg i. v. every 12 h; while the patients in control group received same amount of normal saline. The serum level of amylase at 4, 24 h and TNF-a were determined and the incidence of post-ERCP pancreatitis was documented. Results There were no differences in age, sex and proportion of therapeutic procedures performed between the two groups. The serum amylase and TNF-a levels at 4, 24h were (221 ± 31) U/L, (181 ±39) U/L, (0.264 ±0.052) ng/ml and (0.257 ±0.071) ng/ml in treatment group, respectively; which were significantly lower than (272 ±32) U/L, (227 ±30) U/L, (0. 372 ±0.047) ng/ml and (0.422 ±0.026) ng/ml in the control group (P<0.05). The incidence of pancreatitis in proton pump inhibitors group was 1.6%, which was significantly lower than that in control group (5.6% , P = 0. 04) . Conclusions Combination of proton pump inhibitors and octreotide could effectively decrease the incidence of post-ERCP hyperamylasemia and pancreatitis.
