熊去氧胆酸预防ERCP术后并发症的临床价值  

The clinical values of ursodeoxycholic acid in prevention of postoperative complications of endoscopic retrograde cholangiopancreatography

作　　者：刁同进[1] 赵晓东[2] 

机构地区：[1]济南军区解放军第401医院肝胆外科,青岛266071 [2]济南军区解放军第401医院普外科,青岛266071

出　　处：《肝脏》2014年第3期170-172,192,共4页Chinese Hepatology

摘　　要：目的探讨熊去氧胆酸预防内镜逆行胰胆管造影(ERCP)术后并发症的临床治疗价值。方法回顾性分析62例肝胆胰十二指肠疾病患者ERCP术后的临床资料。熊去氧胆酸组30例采用基础治疗+常规护肝治疗+熊去氧胆酸,熊去氧胆酸剂量为500 mg,2次/d口服,疗程28 d。对照组32例采用基础治疗+常规护肝治疗。比较两组患者术后第3、7、14、28天的临床症状、肝功能、药物不良反应及有效率等。结果 ERCP术后临床症状改善、肝功能指标熊去氧胆酸组明显优于对照组,差异有统计学意义(P<0.05)。应用熊去氧胆酸的30例患者中有7例轻度不适的药物反应,可能无关者3例,无关者3例,无法判断1例;无不良事件及严重不良事件的发生,其药效安全可靠。熊去氧胆酸组30例中,显效14例、有效15例、无效1例,有效率96.7%;对照组32例中,显效14例、有效11例、无效7例,有效率78.1%;两组比较,差异有统计学意义(P<0.05)。结论熊去氧胆酸对ERCP术后临床症状的改善、肝功能的恢复及降低术后并发症有明显的临床治疗价值。Objective To investigate the clinical therapeutic values of ursodeoxycholic acid（UDCA）in prevention of postoperative complications of endoscopic retrograde cholangiopancreatography（ERCP）.Methods The clinical data of 62 cases,which underwent ERCP because of hepatobiliary and pancreatic duodenal diseases in department of hepatobiliary surgery of our hospital from January to September in 2013,was retrospectively analyzed.Among them,there were 45 males （73.3%）and 17 females （26.7%）,range from 24 to 65 years,respectively.In this study,62 patients were randomly divided into treatment group （30 cases）and control group （32 cases）.There were no significant differences in age,gender, preoperative function and biochemical indexes of liver and kidney between two groups.Treatment group was treated with conventional basic therapy,routine liver protective therapy and ursodeoxycholic acid （UDCA）produced by the German FALK pharmaceutical factory,with a daily dose of 20 mg/kg.The dose was 500mg,administrated 2 times/day by oral,and 28 days was a course of treatment.The control group was given the basic treatment and routine treatment without the use of ursodeoxycholic acid.Clinical symptoms at the 3rd,7th,14th,28th day after ERCP operation were observed,such as infection,anorexia,nausea,diarrhea,skin pruritus and jaundice.Results In this study,of 30 patients in treatment group after ERCP by application of ursodeoxycholic acid capsule,mild discomfort was found in 7 cases,while 3 of those were possible independent from adverse drug reaction,3 cases were unrelated and 1 case was unable to j udge.Without evident drug adverse effects and serious adverse events,ursodeoxycholic acid presented its efficacy and safety.The biochemical indexes of liver function in the treatment group after ERCP were better than those of the control group,there was statistically significant difference （P〈0.05 ）.The clinical symptoms after ERCP in the treatment group significantly improved compared with those in control group

关 键 词：熊去氧胆酸 内镜逆行胰胆管造影术 

分 类 号：R656[医药卫生—外科学]