CAJ | 학술논문

目的：探讨预防性应用生长抑素及术后放置胰管支架对经内镜逆行胰胆管造影（ERCP）术后胰腺炎（PEP）及高淀粉酶血症的预防效果。方法将120例行ERCP诊治的高危患者随机分为3组，生长抑素组36例，胰管支架组48例，对照组36例。观察PEP、高淀粉酶血症的发生情况、病情恢复情况。结果3组患者中PEP总发生率为17.5%（21/120），高淀粉酶血症为4.2%（5/120）。对照组PEP、高淀粉酶血症发生率（30.6%、8.3%）明显高于生长抑素组（16.7%、2.8%）和胰管支架组（8.3%、2.1%），差异有统计学意义（P <0.05）。胰管支架组两者的发生率低于生长抑素组（P <0.05）。术后6 h 生长抑素组血清淀粉酶（467±631）U/L、胰管支架组为（501±405）U/L，明显低于对照组[（1323±461）U/L]，差异有统计学意义（P <0.05）；但3组术后24 h血清淀粉酶水平无明显差异（P >0.05）。生长抑素组及胰管支架组胰腺炎患者腹部症状体征消失时间、白细胞计数降至正常时间、平均住院日均较对照组明显缩短,差异有统计学意义（P <0.05）。结论生长抑素、胰管支架置入均可有效预防PEP及高淀粉酶血症的发生。
목적：탐토예방성응용생장억소급술후방치이관지가대경내경역행이담관조영（ERCP）술후이선염（PEP）급고정분매혈증적예방효과。방법장120례행ERCP진치적고위환자수궤분위3조，생장억소조36례，이관지가조48례，대조조36례。관찰PEP、고정분매혈증적발생정황、병정회복정황。결과3조환자중PEP총발생솔위17.5%（21/120），고정분매혈증위4.2%（5/120）。대조조PEP、고정분매혈증발생솔（30.6%、8.3%）명현고우생장억소조（16.7%、2.8%）화이관지가조（8.3%、2.1%），차이유통계학의의（P <0.05）。이관지가조량자적발생솔저우생장억소조（P <0.05）。술후6 h 생장억소조혈청정분매（467±631）U/L、이관지가조위（501±405）U/L，명현저우대조조[（1323±461）U/L]，차이유통계학의의（P <0.05）；단3조술후24 h혈청정분매수평무명현차이（P >0.05）。생장억소조급이관지가조이선염환자복부증상체정소실시간、백세포계수강지정상시간、평균주원일균교대조조명현축단,차이유통계학의의（P <0.05）。결론생장억소、이관지가치입균가유효예방PEP급고정분매혈증적발생。
Objective To investigate the preventive effect of somatostatin and endoscopic duct stents on post-ERCP pancreatitis(PEP) and hyperamylasemia. Methods A total of 120 patients were enrolled and randomly divided into 3 groups to receive somatostatin,endoscopic duct stents, placebo. The incidence of PEP and hyperamylasemia and adverse reactions were observed. Results The overall incidence of PEP and hyperamylasemia were 17.5% (21/120) and 4.2%(5/120), respectively. The level of serum amylase in the somatostatin treatment group[(467±631)U/L], and endoscopic duct stents group [(501±405)U/L] was significantly lower than the control group [(1 323±461)U/L] after 6 h (P <0.05), while the levels of serum amylase 24 h later were not significantly different (P > 0.05). The time of patients with abdominal symptoms presentation and disappearance, the time interval for the returning of normal WBC count or the average length of stay in the somatostatin group and the endoscopic duct stents group were shorter than those of the control group (P <0.05). Comparing the two approaches of PEP prevention, the cost of somatostatin was significantly lower than endoscopic duct stents (P < 0.05). Conclusion Somatostatin and endoscopic duct stents can effectively prevent PEP and hyperamylasemia, but somatostatin is more cost-effective than endoscopic duct stents.