CAJ | 학술논문

目的探讨吲哚美辛对ERCP术后胰腺炎和高淀粉酶血症的预防作用.方法将拟施行ERCP手术的600例患者随机表法分为吲哚美辛组、奥曲肽组和安慰剂对照组,每组200例,观察其术前、术后24 h血清淀粉酶水平,并评估ERCP术后胰腺炎和高淀粉酶血症发生率及预后.结果 3组患者ERCP术前血清淀粉酶均为正常值.ERCP术后24h血清淀粉酶水平,吲哚美辛组[(101.3±77.7)U/L]低于奥曲肽组[(176.6±138.3)U/L]及对照组[(227.2±264.9) U/L],差异均有统计学意义(P=0.040,P=0.048)；奥曲肽组低于对照组,但差异没有显著意义(P＞0.05).ERCP术后胰腺炎发生率,吲哚美辛组(2.5％)低于对照组(9.5％),差异有显著性意义(P=0.003)；奥曲肽组(4.5％)低于对照组,但无统计学差异(P=0.05).ERCP术后高淀粉酶血症发生率,吲哚美辛组(5.5％)低于对照组(13.5％),差异有显著性意义(P=0.006)；奥曲肽组(10.0％)低于对照组,但差异没有统计学意义(P＞0.05).结论 ERCP术前应用吲哚美辛可有效降低胰腺炎和高淀粉酶血症的发生率.
목적 탐토신타미신대ERCP술후이선염화고정분매혈증적예방작용.방법 장의시행ERCP수술적600례환자수궤표법분위신타미신조、오곡태조화안위제대조조,매조200례,관찰기술전、술후24 h혈청정분매수평,병평고ERCP술후이선염화고정분매혈증발생솔급예후.결과 3조환자ERCP술전혈청정분매균위정상치.ERCP술후24h혈청정분매수평,신타미신조[(101.3±77.7)U/L]저우오곡태조[(176.6±138.3)U/L]급대조조[(227.2±264.9) U/L],차이균유통계학의의(P=0.040,P=0.048)；오곡태조저우대조조,단차이몰유현저의의(P＞0.05).ERCP술후이선염발생솔,신타미신조(2.5％)저우대조조(9.5％),차이유현저성의의(P=0.003)；오곡태조(4.5％)저우대조조,단무통계학차이(P=0.05).ERCP술후고정분매혈증발생솔,신타미신조(5.5％)저우대조조(13.5％),차이유현저성의의(P=0.006)；오곡태조(10.0％)저우대조조,단차이몰유통계학의의(P＞0.05).결론 ERCP술전응용신타미신가유효강저이선염화고정분매혈증적발생솔.
Objective To investigate the preventive effect of Indomethacin for post-ERCP pancreatitis and hyperamylasemia.Methods A total of 600 patients,who were undergoing ERCP,were randomly divided into 3 groups to receive anal Indomethacin (n=200),intravenous octreotide (n=200) or no special medication (n=200) before ERCP.The level of serum amylase before and 24h after ERCP were measured,and the rate of acute pancreatitis and hyperamylasemia after ERCP were assessed.Results Serum amylase levels before ERCP of all groups were normal.The mean serum amylase level of Indomethacin group (101.3±77.7 U/L) after ERCP was significantly lower than those of octreotide group ( 176.6±138.3 U/L,P =0.040 ]and control group (227.2±264.9 U/L,P=0.048),while there was no difference between octreotide group and control group ( P＞0.05 ).The incidence of post-ERCP pancreatitis in Indomethacin group (2.5％) was significantly lower than that of control group (9.5％,P=0.003),while there was no difference between octreotide group (4.5％) and control group ( P=0.05 ).The incidence of hyperamylasemia after ERCP in Indomethacin group (5.5％) was significantly lower than that of control group ( 13.5％,P=0.006 ),while there was no difference between octreotide group (10.0％) and control group ( P＞0.05 ).Conctusion Anal administration of Indomethacin before ERCP can effectively reduce the incidence of acute pancreatitis and hyperamylasemia after ERCP.