胰管支架预防高危ERCP术后胰腺炎的临床分析  

Clinical analysis of pancreatic duct stents in the prevention of post-ERCP pancreatitis

作　　者：刘璐[1] 邓涛[1] 万新月[1] 覃念[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》2013年第11期1087-1090,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察胰管支架置入预防高危患者内镜逆行胰胆管造影(ERCP)术后胰腺炎及高淀粉酶血症的效果。方法将确定有ERCP指征并符合纳入标准的72例高危患者按照随机数字表法分为胰管支架组和对照组,每组36例。比较两组术后3 h、24 h血清淀粉酶水平及高淀粉酶血症、急性胰腺炎、重症胰腺炎的发生率。结果胰管支架组术后3 h和术后24 h血淀粉酶值分别为(128.68±173.35)U/L和(92.41±88.44)U/L,均低于对照组(432.37±515.20)U/L和(465.89±736.54)U/L,差异有统计学意义(P<0.05);胰管支架组术后高淀粉酶血症、急性胰腺炎、重症胰腺炎的发生率分别为5.6%、2.8%、0,对照组为22.2%、16.7%、11.1%,两组比较差异有统计学意义(P<0.05)。结论胰管支架置入能明显降低高危患者ERCP术后高淀粉酶血症、急性胰腺炎及重症胰腺炎的发生率。Objective To observe the effects of pancreatic duct stents in the prevention of post-endoscopic retrograde cholangiopancreatography （ERCP） pancreatitis and hyperamylasemia in high-risk patiens.Methods Seventy-two high-risk patients who were identified with ERCP indications were divided into pancreatic duct stents group and control group by random digits table.The postoperative serum amylase value at 3 h and 24 h,incidence of hyperamylasemia,post-ERCP pancreatitis,severe post-ERCP pancreatitis were compared between two groups.Results The postopemtive serum amylase value at 3 h and 24 h were obviously lower in pancreatic duct stents group than those in control group [（128.68-± 173.35）U/L vs （432.37 ±515.20）U/L,P ＜0.05; （92.41 ± 88.44） U/L vs （465.89 ±736.54）U/L,P ＜ 0.05].The incidence of hyperamylasemia,post-ERCP pancreatitis,severe post-ERCP pancreatitis were also significantly lower in pancreatic duct stents group than those in control group （5.6％ vs 22.2％,2.8％ vs 16.7％,0 vs 11.1％,P ＜ 0.05）.Conclusion Pancreatic duct stents can distinctly prevent the incidence of hyperamylasemia,post-ERCP pancreatitis,severe post-ERCP pancreatitis in high-risk patiens.

关 键 词：ERCP术后急性胰腺炎 胰管支架 内镜逆行胰胆管造影术 高危患者 

分 类 号：R576[医药卫生—消化系统]