CAJ | 학술논문

目的：探讨生长抑素预防内镜逆行胆胰管造影术（ERCP）术后胰腺炎及高淀粉酶血症的作用。方法570例胆胰疾病患者分为术前组127例，术后组153例，全程组189例，对照组101例，观察术后胰腺炎及高淀粉酶血症的发生情况。术前组为术前6h予以生长抑素3mg，每12小时1次微量泵泵入；术后组为术后12h内使用生长抑素3mg，每12小时1次微量泵泵入；全程组则为术前6h及术后12h持续生长抑素3mg，每12小时1次微量泵泵入，共18h；对照组则为500mL生理盐水滴注。观察术后24h淀粉酶水平和患者有无急性胰腺炎的临床表现。结果术后胰腺炎总发病率为4．04％，高淀粉酶血症总发病率为23．86％。术前组、术后组、全程组及对照组术后高淀粉酶血症的发生率分别为23．62％、21．57％、13．23％、47．52％，术后胰腺炎的发生率分别为3．15％、4．58％、1．59％、8．91％。各用药组与对照组比较，术后胰腺炎及高淀粉酶血症均明显降低（P＜0．05）。用药组间比较，全程组术后高淀粉酶血症发生率明显低于术前组、术后组（P＜0．05）。结论不同时期使用生长抑素可明显降低ERCP术后高淀粉酶血症及胰腺炎的发生，而术前及术后持续用药对其预防作用更佳。
목적：탐토생장억소예방내경역행담이관조영술（ERCP）술후이선염급고정분매혈증적작용。방법570례담이질병환자분위술전조127례，술후조153례，전정조189례，대조조101례，관찰술후이선염급고정분매혈증적발생정황。술전조위술전6h여이생장억소3mg，매12소시1차미량빙빙입；술후조위술후12h내사용생장억소3mg，매12소시1차미량빙빙입；전정조칙위술전6h급술후12h지속생장억소3mg，매12소시1차미량빙빙입，공18h；대조조칙위500mL생리염수적주。관찰술후24h정분매수평화환자유무급성이선염적림상표현。결과술후이선염총발병솔위4．04％，고정분매혈증총발병솔위23．86％。술전조、술후조、전정조급대조조술후고정분매혈증적발생솔분별위23．62％、21．57％、13．23％、47．52％，술후이선염적발생솔분별위3．15％、4．58％、1．59％、8．91％。각용약조여대조조비교，술후이선염급고정분매혈증균명현강저（P＜0．05）。용약조간비교，전정조술후고정분매혈증발생솔명현저우술전조、술후조（P＜0．05）。결론불동시기사용생장억소가명현강저ERCP술후고정분매혈증급이선염적발생，이술전급술후지속용약대기예방작용경가。
Objective To investigate the preventive role of somatostatin in acute pancreatitis and hyperamylasemia induced by endoscopic retrograde cholangiopancre aticography (ERCP) in different periods .Methods 570 cases were divided into four groups , the preoperative group(127 cases) ,the postoperative group(153 cases) ,the whole group(189 cases) and the control groups(101 ca-ses) ,and occurrences of acute pancreatitis and hyperamylasemia were observed .6 h before the operation ,the preoperative group was given 3 mg somatostatin per 12 h by microdosis venous pump .In 12 h after the operation ,the postoperative group was given 3 mg somatostatin per 12 h by microdosis venous pump ,the whole group was given somatostatin 6 h before and 12 h after the operation , the control group was injected normal saline .Measurement of hyperamylasemia was made in 24 h after ERCP ,and clinical manifes-tations of acute pancreatitis were also observed .Results The incidences of PEP and hyperamylasemia were 4 .04% ,23 .86% ,re-spectively .The incidences of hyperamylasemia among the four groups were 23 .62% ,21 .57% ,13 .23% and 47 .52% ,and the inci-dences of PEP were 3 .15% ,4 .58% ,1 .59% ,8 .91% .The incidences of hyperamylasemia and PEP in somatostatin used groups were statistical lower than the control group(P<0 .05) .Compared with the preoperative group and the postoperative group ,the incidence of hyperamylasemia in the whole group had significant difference(P<0 .05) .Compare witn the postoperative group ,the incidence of PEP in the whole group also had significant difference(P<0 .05) .Conclusion Use of somatostatin can reduce the incidence of PEP and hyperamylasemia ,and the use of somatostatin before and after the operation have a better preventive effect .