ENBD预防胆总管结石ERCP术后急性胰腺炎及高淀粉酶血症的临床价值  

The clinical value of ENBD in the prevention of post-ERCP pancreatitis and hyperamylasemia in patients with common bile duct stones

作　　者：余璐[1] 邓涛[1] 占义军[1] 皮小雨[1] 李红艳[1] 

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2012年第4期316-318,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察内镜鼻胆管引流术(ENBD)预防内镜逆行胰胆管造影术(ERCP)术后急性胰腺炎及高淀粉酶血症的效果。方法收集我院胆总管结石行ERCP取石术的患者367例,其中ENBD组309例,对照组58例,比较两组术后2 h及24 h血清淀粉酶值、高淀粉酶血症及急性胰腺炎的发生率。结果 ENBD组术后2 h、24 h的血清淀粉酶值分别为(396.6±240.3)U/L和(620.8±345.5)U/L,明显低于对照组的(593.9±470.5)U/L和(1 074.0±609.1)U/L(P<0.05);ENBD组有42例发生高淀粉酶血症(13.6%)、15例发生急性胰腺炎(4.9%),对照组则分别为13例(22.4%)和8例(13.8%),两组比较差异均有统计学意义(P<0.05)。结论 ENBD能有效预防胆总管结石患者ERCP术后急性胰腺炎及高淀粉酶血症的发生。Objective To investigate the efficacy of endoscopic nasobiliary drainage（ENBD） in the prevention of post-endoscopic retrograde cholangiopancreatography（ERCP） pancreatitis and hyperamylasemia in patients with common bile duct stones.Methods The clinical data of 367 patients with common bile duct stones,including 309 undergoing ENBD and 58 undergoing routine treatment,were reviewed retrospectively.Serum amylase levels at 2 h and 24 h postoperatively and incidence of pancreatitis and hyperamylasemia were compared between the two groups.Results Serum amylase levels at 2 h and 24 h postoperatively were significantly lower in the ENBD group than those in the routine treatment group（396.6 U/L±240.3 U/L vs 593.9 U/L±470.5 U/L,P0.05;620.8 U/L±345.5 U/L vs 1074.0 U/L±609.1 U/L,P0.01）.The incidence of post-ERCP pancreatitis and hyperamylasemia were also significantly lower in the ENBD group than those in the routine treatment group（4.9% vs 13.8%,13.6% vs 22.4%,both P0.05）.Conclusion ENBD can effectively prevent the occurrence of post-ERCP pancreatitis and hyperamylasemia in patients with common bile duct stones.

关 键 词：内镜逆行胰胆管造影术 鼻胆管引流 急性胰腺炎 高淀粉酶血症 

分 类 号：R657.51[医药卫生—外科学] R576[医药卫生—临床医学]