中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
15期
6851-6854
,共4页
胰胆管造影术,内窥镜逆行%胰腺炎%高淀粉酶血症%马来酸盐类
胰膽管造影術,內窺鏡逆行%胰腺炎%高澱粉酶血癥%馬來痠鹽類
이담관조영술,내규경역행%이선염%고정분매혈증%마래산염류
Cholangiopancreatography,endoscopic retrograde%Pancreatitis%Hyperamylasemia%Maleates
目的：探讨马来酸曲美布汀对内镜逆行胰胆管造影（ERCP）术后胰腺损伤发病率的影响及安全性。方法入选我院自2012年6至12月收治的拟施行ERCP患者72例。患者随机分为马来酸曲美布汀组（n＝36）和对照组（n＝36）。术前60 min两组患者分别口服马来酸曲美布汀200 mg及安慰剂（维生素C 0.2 g）。观察 ERCP 术后血清淀粉酶水平及胰腺炎、高淀粉酶血症发生情况，观察术后腹痛黄疸情况及不良反应。结果马来酸曲美布汀组血清淀粉酶低于对照组，术后2 h两组差异有统计学意义（P＝0.037）。72例中，ERCP术后急性胰腺炎（PEP）发生率为6.94%（5例），高淀粉酶血症发生率为26.4%（19例）。其中，胰腺炎的发生率，马来酸曲美布汀组低于对照组（5.6%vs.8.3%），但差异无统计学意义（χ2＝1.687， P＝0.134）。高淀粉酶血症的发生率，马来酸曲美布汀组低于对照组（19.4%vs.33.3%），差异有统计学意义（χ2＝5.016，P＝0.025）。马来酸曲美布汀组 ERCP 术后腹痛分级明显低于对照组，两组差异有显著性（P＝0.008）。马来酸曲美布汀组ERCP术后直接胆红素（DBIL）与对照组同期比较有下降，差异有统计学意义（P＝0.047）。但ERCP术后胆管炎发生率两组比较差异无统计学意义（P＝0.178）。两组均未出现严重不良反应。结论 ERCP术前口服马来酸曲美布汀对降低术后高淀粉酶血症的发生有益；并能辅助减轻腹痛。马来酸曲美布汀药物安全性好。
目的：探討馬來痠麯美佈汀對內鏡逆行胰膽管造影（ERCP）術後胰腺損傷髮病率的影響及安全性。方法入選我院自2012年6至12月收治的擬施行ERCP患者72例。患者隨機分為馬來痠麯美佈汀組（n＝36）和對照組（n＝36）。術前60 min兩組患者分彆口服馬來痠麯美佈汀200 mg及安慰劑（維生素C 0.2 g）。觀察 ERCP 術後血清澱粉酶水平及胰腺炎、高澱粉酶血癥髮生情況，觀察術後腹痛黃疸情況及不良反應。結果馬來痠麯美佈汀組血清澱粉酶低于對照組，術後2 h兩組差異有統計學意義（P＝0.037）。72例中，ERCP術後急性胰腺炎（PEP）髮生率為6.94%（5例），高澱粉酶血癥髮生率為26.4%（19例）。其中，胰腺炎的髮生率，馬來痠麯美佈汀組低于對照組（5.6%vs.8.3%），但差異無統計學意義（χ2＝1.687， P＝0.134）。高澱粉酶血癥的髮生率，馬來痠麯美佈汀組低于對照組（19.4%vs.33.3%），差異有統計學意義（χ2＝5.016，P＝0.025）。馬來痠麯美佈汀組 ERCP 術後腹痛分級明顯低于對照組，兩組差異有顯著性（P＝0.008）。馬來痠麯美佈汀組ERCP術後直接膽紅素（DBIL）與對照組同期比較有下降，差異有統計學意義（P＝0.047）。但ERCP術後膽管炎髮生率兩組比較差異無統計學意義（P＝0.178）。兩組均未齣現嚴重不良反應。結論 ERCP術前口服馬來痠麯美佈汀對降低術後高澱粉酶血癥的髮生有益；併能輔助減輕腹痛。馬來痠麯美佈汀藥物安全性好。
목적：탐토마래산곡미포정대내경역행이담관조영（ERCP）술후이선손상발병솔적영향급안전성。방법입선아원자2012년6지12월수치적의시행ERCP환자72례。환자수궤분위마래산곡미포정조（n＝36）화대조조（n＝36）。술전60 min량조환자분별구복마래산곡미포정200 mg급안위제（유생소C 0.2 g）。관찰 ERCP 술후혈청정분매수평급이선염、고정분매혈증발생정황，관찰술후복통황달정황급불량반응。결과마래산곡미포정조혈청정분매저우대조조，술후2 h량조차이유통계학의의（P＝0.037）。72례중，ERCP술후급성이선염（PEP）발생솔위6.94%（5례），고정분매혈증발생솔위26.4%（19례）。기중，이선염적발생솔，마래산곡미포정조저우대조조（5.6%vs.8.3%），단차이무통계학의의（χ2＝1.687， P＝0.134）。고정분매혈증적발생솔，마래산곡미포정조저우대조조（19.4%vs.33.3%），차이유통계학의의（χ2＝5.016，P＝0.025）。마래산곡미포정조 ERCP 술후복통분급명현저우대조조，량조차이유현저성（P＝0.008）。마래산곡미포정조ERCP술후직접담홍소（DBIL）여대조조동기비교유하강，차이유통계학의의（P＝0.047）。단ERCP술후담관염발생솔량조비교차이무통계학의의（P＝0.178）。량조균미출현엄중불량반응。결론 ERCP술전구복마래산곡미포정대강저술후고정분매혈증적발생유익；병능보조감경복통。마래산곡미포정약물안전성호。
Objective To study the impact on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatic injury with maleates trimebutine. Methods From June to December 2012 total 72 patients with normal serum amylase and without cholangitis underwent ERCP were admitted in our hospital. The patients were randomly divided into maleates trimebutine group(36 cases) and control group(36 cases). 2 groups were given 200 mg maleates trimebutine or Vitamin C 0.2 g at 60 minutes before ERCP. The mean concentrations of serum amylase at 2 h, 24 h and 48 h after ERCP were measured in all patients. The incidence of PEP and hyperamylasemia and adverse reactions were observed.The abdominal pain and stained yellow before and after ERCP were also observed. Results The serum amylase level of maleates trimebutine group was lower than the controls. There was a difference between the two groups at 2 h after ERCP(P=0.037). The overall incidences of PEP and hypcramylasemia were 6.94%(5/72)and 26.4%(19/72). Respectively, the incidence of hyperamylasemia in maleates trimebutine group(7/36, 19.4%)was significantly lower than that of control group(12/36,33.3%)(χ2=5.016, P=0.025). Incidence of PEP in maleates trimebutine group(2/36,5.6%)was lower than that of control group(3/36, 8.3%) without significance(χ2=1.687, P=0.134). The abdominal pain grading of maleates trimebutine group was lower than the controls.There was a significant difference(P=0.008). The DBIL level of maleates trimebutine group were lower than the controls. There was a difference(P=0.047). But the incidence of cholangitis had no difference (P=0.178). No severe adverse effects was observed. Conclusions Maleates trimebutine is used in pre-ERCP may be beneficial for reducing the incidence of hyperamylasemia and can help to reduce abdominal pain.Maleates trimebutine is safe.
