生长抑素联合左氧氟沙星或头孢派酮他唑巴坦在ERCP术后胰腺炎预防中的作用  

作　　者：张瑜[1] 张志强[1] 张健康[2] 

机构地区：[1]山西医科大学,山西030000 [2]山西医科大学第一医院

出　　处：《当代医学》2014年第6期143-144,共2页Contemporary Medicine

摘　　要：目的观察生长抑素联合左氧氟沙星或头孢派酮他唑巴坦在ERCP术后胰腺炎中的预防作用。方法术前血清淀粉酶在正常范围内拟行ERCP术患者随机分为三组,即生长抑素组27例,生长抑素+左氧氟沙星组33例,生长抑素+头孢派酮他唑巴坦组35例。生长抑素组术后当日予以生长抑素250μg/h静脉泵入,持续1 d,生长抑素+左氧氟沙星组术后当日予以生长抑素250μg/h静脉泵入+左氧氟沙星0.3 g/d静脉点滴,用药1 d,生长抑素+头孢派酮他唑巴坦组术后当日予以生长抑素250μg/h静脉泵入+头孢派酮他唑巴坦6 g/d静脉点滴,用药1 d,观察患者症状体征、术后2、12、24 h血清淀粉酶。结果生长抑素组、生长抑素+左氧氟沙星组、生长抑素+头孢派酮组ERCP术后胰腺炎的发生率分别为22.22%、3.03%、2.86%。生长抑素组与生长抑素+左氧氟沙星组比较,差异有统计学意义(P<0.05),生长抑素组与生长抑素+头孢派酮组比较,差异有统计学意义(P<0.05),生长抑素+左氧氟沙星组与生长抑素+头孢派酮组比较,差异无统计学意义。结论生长抑素联合抗生素可更好的预防ERCP术后胰腺炎的发生,联合头孢哌酮他唑巴坦的预防作用与联合左氧氟沙星效果无明显差别。Objective To observe the prevention effect of somatostatin combined with levofloxacin or Cefoperazone-tazobactam on post-ERCP pancreatitis. Methods Patients undergoing ERCP treatment with a normal serum amylase range were randomly divided into three groups based on the agent given following the ERCP procedure：somatostatin 250 μg/h intravenous pump ,l day（27 case）, somatostatin 250 μg/h intravenous pump ＋ levofloxacin 0.3 g/day intravenous drip, 1 day（33 case）, somatostatin 250 ug/h intravenous pump ＋ Cefoperazone-tazobactam 6 g/day intravenous drip, 1 day（35 case）. Observe patients＇ symptoms and signs, serttrn amylase at of 2,12,24 h after ERCP. Results The incidence of post-ERCP pancreatitis of Somatostatin group,somatostatin ＋ levofloxacin group and Somatostatin ＋Cefoperazone-tazobactam group were 22.22%, 3.03% and 2.86% respectively. There were significant difference between Somatostatin and somatostatin ＋levofloxacin groups（P 〈 0.05）,somatostatin and somatostatin＋ Cefoperazone-tazobactam groups （P〈0.05）, and somatostatin＋levofloxacin and somatostatin ＋ Cefoperazone-tazobactam groups. Conclusion Somatostatin combined antibiotics can better prevent the happening of the post-ERCP pancreatitis. Somatostatin combined Cefoperazone- tazobactam has no significant different fleet with Somatostatin combined levofloxacin.

关 键 词：生长抑素 左氧氟沙星 头孢派酮他唑巴坦 ERCP ERCP术后胰腺炎 

分 类 号：R657.51[医药卫生—外科学]