CAJ | 학술논문

目的：探讨熊去氧胆酸预防内镜逆行胰胆管造影(ERCP)术后并发症的临床治疗价值。方法回顾性分析62例肝胆胰十二指肠疾病患者 ERCP术后的临床资料。熊去氧胆酸组30例采用基础治疗+常规护肝治疗+熊去氧胆酸,熊去氧胆酸剂量为500 mg,2次/d口服,疗程28 d。对照组32例采用基础治疗+常规护肝治疗。比较两组患者术后第3、7、14、28天的临床症状、肝功能、药物不良反应及有效率等。结果 ERCP 术后临床症状改善、肝功能指标熊去氧胆酸组明显优于对照组,差异有统计学意义(P<0.05)。应用熊去氧胆酸的30例患者中有7例轻度不适的药物反应,可能无关者3例,无关者3例,无法判断1例；无不良事件及严重不良事件的发生,其药效安全可靠。熊去氧胆酸组30例中,显效14例、有效15例、无效1例,有效率96.7%；对照组32例中,显效14例、有效11例、无效7例,有效率78.1%；两组比较,差异有统计学意义(P<0.05)。结论熊去氧胆酸对 ERCP 术后临床症状的改善、肝功能的恢复及降低术后并发症有明显的临床治疗价值。
목적：탐토웅거양담산예방내경역행이담관조영(ERCP)술후병발증적림상치료개치。방법회고성분석62례간담이십이지장질병환자 ERCP술후적림상자료。웅거양담산조30례채용기출치료+상규호간치료+웅거양담산,웅거양담산제량위500 mg,2차/d구복,료정28 d。대조조32례채용기출치료+상규호간치료。비교량조환자술후제3、7、14、28천적림상증상、간공능、약물불량반응급유효솔등。결과 ERCP 술후림상증상개선、간공능지표웅거양담산조명현우우대조조,차이유통계학의의(P<0.05)。응용웅거양담산적30례환자중유7례경도불괄적약물반응,가능무관자3례,무관자3례,무법판단1례；무불량사건급엄중불량사건적발생,기약효안전가고。웅거양담산조30례중,현효14례、유효15례、무효1례,유효솔96.7%；대조조32례중,현효14례、유효11례、무효7례,유효솔78.1%；량조비교,차이유통계학의의(P<0.05)。결론웅거양담산대 ERCP 술후림상증상적개선、간공능적회복급강저술후병발증유명현적림상치료개치。
Objective To investigate the clinical therapeutic values of ursodeoxycholic acid(UDCA)in prevention of postoperative complications of endoscopic retrograde cholangiopancreatography(ERCP).Methods The clinical data of 62 cases,which underwent ERCP because of hepatobiliary and pancreatic duodenal diseases in department of hepatobiliary surgery of our hospital from January to September in 2013,was retrospectively analyzed.Among them,there were 45 males (73.3%)and 17 females (26.7%),range from 24 to 65 years,respectively.In this study,62 patients were randomly divided into treatment group (30 cases)and control group (32 cases).There were no significant differences in age,gender, preoperative function and biochemical indexes of liver and kidney between two groups.Treatment group was treated with conventional basic therapy,routine liver protective therapy and ursodeoxycholic acid (UDCA)produced by the German FALK pharmaceutical factory,with a daily dose of 20 mg/kg.The dose was 500mg,administrated 2 times/day by oral,and 28 days was a course of treatment.The control group was given the basic treatment and routine treatment without the use of ursodeoxycholic acid.Clinical symptoms at the 3rd,7th,14th,28th day after ERCP operation were observed,such as infection,anorexia,nausea,diarrhea,skin pruritus and jaundice.Results In this study,of 30 patients in treatment group after ERCP by application of ursodeoxycholic acid capsule,mild discomfort was found in 7 cases,while 3 of those were possible independent from adverse drug reaction,3 cases were unrelated and 1 case was unable to j udge.Without evident drug adverse effects and serious adverse events,ursodeoxycholic acid presented its efficacy and safety.The biochemical indexes of liver function in the treatment group after ERCP were better than those of the control group,there was statistically significant difference (P<0.05 ).The clinical symptoms after ERCP in the treatment group significantly improved compared with those in control group (P<0.05).In treatment group,14 cases (46.7%)were significantly effective,15 cases (50%)were effective,1 case (3.3%)was invalid,with the total efficiency of 93.3%.While in control group,14 cases (43.8%)were significantly effective,11 cases (34.4%)were effective,7 cases (21.9%)were invalid, with the total efficiency of 78.1%.Compared with the total clinical effective rate of the two groups,the additional application of UDCA in the treatment group had significantly better outcomes than that of the control group,the difference was statistically significant (P<0.05).Conclusions Ursodeoxycholic acid capsule has obvious clinical therapeutic value which significantly improved clinical symptoms and liver function, and reduced the occurrence of postoperative complications.