大黄保留灌肠预防逆行胰胆管造影术后胰腺炎和高淀粉酶血症的临床研究  

Preventive effect of Rhubarb for post-ERCP pancreatitis and hyperamylasemia

作　　者：王苏丽[1] 周毅[1] 姚茹[1] 王钧[1] 林涛[1] 谢艳[1] 

机构地区：[1]解放军第四五一医院消化内科,陕西西安710054

出　　处：《中国中西医结合消化杂志》2012年第12期545-547,共3页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]观察生大黄保留灌肠对逆行胰胆管造影(Endoscopic Retrograde Cholangio-Pancreatography,ER-CP)术后并发胰腺炎(Post-ERCP-Panreatitis,PEP)和高淀粉酶血症的的预防作用。[方法]选取2008年3月～2010年6月在我院消化科住院需行ERCP检查及相关治疗的患者共300例,随机分为2组。观察2组患者术前、术后6h血清淀粉酶水平,并评估ERCP术后胰腺炎和高淀粉酶血症发生率及预后。[结果]所有患者术前血淀粉酶均正常。ERCP术后6h血清淀粉酶水平,大黄组[(167.2±87.9)U/L]低于对照组[(234.5±214.3)U/L],2组比较差异有统计学意义(P<0.05);ERCP术后高淀粉酶血症的发生率,大黄组(8.3%)低于对照组(18.7%),2组比较差异有统计学意义(P<0.05);ERCP术后PEP的发生,大黄组(4.0%)低于对照组(6.0%),2组间差异无统计学意义(P>0.05)。[结论]ERCP术后应用大黄保留灌肠可有效降低ERCP术后高淀粉酶血症的发生率,但对术后胰腺炎的预防无统计学意义。[Objective]To investigate the preventive effect of Rhubarb for post-ERCP pancreatitis and hyperamylasemia.[Methods]A total of 300 patients,who were undergoing ERCP,were randomly divided into Rhubarb and control groups,150 in each group.Preoperative and 6-hour-postoperative serum amylase levels were obtained.Occurrence of post-ERCP pancreatitis and hyperamylasemia and prognosis were assessed.[Results]Serum amylase levels before ERCP in both groups were normal.The serum amylase level of Rhubarb group 6 hours after surgery [（167.2 ±87.9） U / L] was lower than the control group [（234.5 ±214.3） U / L],which was significantly different（P0.05）.The incidence of post-ERCP pancreatitis of Rhubarb group（4.0%） was lower than that of control group（6.0%）（P0.05）.Post-ERCP hyperamylasemia incidence of Rhubarb group（8.3%）was lower than that of the control group（18.7%）,which was significantly different（P0.05）.[Conclusion]Administration of Rhubarb after ERCP can effectively reduce the incidence of hyperamylasemia.

关 键 词：大黄 逆行胰胆管造影术 内窥镜 胰腺炎 高淀粉酶血症 

分 类 号：R730.71[医药卫生—肿瘤] R576[医药卫生—临床医学]