含乌司他丁造影剂胰管显影与ERCP术后胰腺炎相关性研究  

Clinical randomizing control trial for the imaging of pancreatic duct and post ERCP pancreatitis:a method using a contrast medium with Ulinastatin

作　　者：王建平[1] 苏进根[1] 陆奕宁[1] 周海华[1] 龚彪[2] 

机构地区：[1]上海交通大学医学院附属仁济医院嘉定分院,上海201800 [2]上海交通大学医学院附属瑞金医院消化内镜科,上海200025

出　　处：《中国实用内科杂志》2010年第3期256-256,257,260,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的用含乌司他丁造影剂显影胰管,以观察ERCP术后胰腺炎的发生率和预防的临床对照研究。方法将2008年1月至2009年7月上海交通大学医学院附属仁济医院嘉定分院178例患者随机分成对照组85例、实验组93例,实验组用含乌司他丁造影剂显影胰管、而对照组用常规造影剂,操作要求用缓力推注造影剂且仅显示主胰管。结果178例发生ERCP术后胰腺炎共15例,发生率为8.9%,其中对照组11例、占12.9%(11/85),实验组4例、占4.3%(4/93),两组发生率比较差异有统计学意义P<0.05,诊断性ERCP术后胰腺炎发生率,对照组和实验组分别为44.4%(4/9)和14.3%(1/7),统计分析差异无统计学意义P>0.05。全部患者为轻型胰腺炎,经保守治疗痊愈。结论在ERCP术操作中使用含乌司他丁造影剂显影胰管,能降低ERCP术后胰腺炎的发生率,但不能完全避免术后胰腺炎的发生。Objective The aim of this trail for the observation and prevention to incidence rate of Post ERCP Pancreatitis （PEP） by using the contrast medium with contained Uinastatin to developing of pancreatic duct after ERCP procedure. Methods 178 patients were selected to perform ERCP procedure from 2008. 1 to 2009. 1 ,that were divided into two groups, in which 93 cases in study group were been imaged the pancreatic duct by using contrast media with contained Ulinastatin, and 85 patients in control group by developing of pancreatic duct with conventional medium. The degree of developing pancreatic duct was controlled to limit master pancreatic duct by softly injection pressure,not to exposure its branches. Results 15 of 178 cases occurred to the post ERCP pancreatitis, total incidence rate of 8. 9%, which of 11 cases were in control group, and 4 patients in study group. The incidence rate of PEP was 12. 9% in control group and 4. 3 % in study group, that were significant differences to compare the results between both groups （ P 〈 0. 05 ）. The incidence rate of PEP after diagnostic ERCP was 44.4% 4/9 ） and 14. 3% （1/7） in control group and study group, respectively, the statistical analysis demonstrated no significant differences between both groups （P 〉 0. 05 ）. The symptom of PEP presented slightly in 15 patients, they were cured by conservative therapy. Conclusion The incidence rate of PEP can be reduced by using contained Ulinastatin contrast medium to developing of pancreatic duct after ERCP procedure, but not yet to avoid the occurrence of post ERCP pancreatitis entirely.

关 键 词：逆行胰胆造影术 ERCP术后胰腺炎 造影剂 乌司他丁 

分 类 号：R5[医药卫生—内科学]