经直肠使用双氯芳酸钠对双气囊内镜术后淀粉酶和脂肪酶的影响分析  

Effect of rectal diclofenac on incidence of hyperamylasemia and hyperlipasemia after double-balloon enteroscopy

作　　者：万新月[1] 邓涛[1] 沈磊[1] 

机构地区：[1]武汉大学人民医院消化内科,430060

出　　处：《中华全科医师杂志》2015年第7期552-555,共4页Chinese Journal of General Practitioners

摘　　要：将116例121例次接受经口双气囊内镜（DBE）检查术患者随机分为对照组（65例次）和双氯芳酸钠干预组（56例次），干预组术前1h直肠用药双氯芬酸钠栓50mg，比较两组患者术前，术后4h和24h血淀粉酶和脂肪酶变化。结果显示，对照组、干预组术后4h高淀粉酶血症发生率分别为38．5％、33．9％，高脂肪酶血症发生率分别为36．9％、21．4％；术后24h高淀粉酶血症发生率分别为24．6％、19．6％，高脂肪酶血症发生率分别为15．4％、10．7％。术后两组4h、24h高淀粉酶血症和高脂肪酶血症发生率差异均无统计学意义（均P〉0．05）。术后共出现1例急性轻型胰腺炎和1例术后}肖化道出血，未见其他严重并发症。提示高淀粉酶血症和高脂肪酶血症是DBE术后常见的一过性现象，而术前经直肠使用双氯芬酸钠不能降低其术后发生率。To evaluate the efficacy of the prophylactic use of diclofenac in prevention of hyperarrlylasemia and hyperlipasemia in patients undergoing double-balloon enteroscopy （DBE）. One hundred and sixteen patients undergoing peroral DBE were enrolled in the study. Total 121 procedures were performed, in 56 procedures diclofenac sodium 50 mg was administered by rectum 1 h before the peroral DBE （intervention group） and in 65 procedures no medication was given （control group）. Serum amylase and lipase levels were measured before and 4 h, 24 h after the procedure. At 4 h after DBE the incidence rates of hyperamylasemia and hyperlipasemia in intervention and control groups were 33.9% , 38.5% （P 〉 0.05） and 21, 4%, 36. 9% （P 〉 0.05）, respectively. At 24 h after DBE, the incidence rates of hyperamylasemia and hyperlipasemia in intervention and control groups were 19.6% , 24. 6% （ P 〉 0. 05 ） and 10. 7%, 15.4% （P 〉 0. 05）, respectively. Mild acute pancreatitis developed in one patient and gastrointestinal hemorrhage occurred in another patient. Hyperamylasemia and hyperlipasemia is common and transient ＇after double-balloon enteroscopy, and rectal administration of diclofenac sodium cannot effectively reduce the incidence.

关 键 词：高淀粉酶血症 脂肪酶 双气囊内镜 

分 类 号：R574[医药卫生—消化系统]