中药灌肠预防ERCP术后胰腺炎的临床分析  

作　　者：刘华[1] 毛建生[1] 

机构地区：[1]浙江衢化医院消化内科324004

出　　处：《浙江临床医学》2017年第12期2185-2186,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省衢州市指导性科技项目（2014161）

摘　　要：目的探讨柴芍承气汤保留灌肠预防胰腺炎（PEP）的安全性及有效性。方法选取2014年6月至2016年9月行内镜下逆行胰胆管造影术（ERCP）的患者158例，随机分为中药组64例和西药组64例、对照组30例，对照组术后予以鼻胆管引流，应用头孢三代抗生素，维持水、电解质平衡等。中药组在对照组处理的基础上，ERCP术后30min予柴芍承气汤保留灌肠，西药ERCP术后30min予吲哚美辛栓0．1塞肛。检测三组患者ERCP术前和术后3h、24h淀粉酶水平，并观察有无消化道出血、心衰、肾功能损害等并发症。结果中药组与西药组均能达到预防PEP、PEH的目的，但中药组PEP、PEH发生率低于西药组（P〈0．05）；中药组无一例出现肾功能损害、心功能衰竭、出血等并发症；中药组术后出血发生率明显低于西药组（P〈0．05）。结论柴芍承气汤保留灌肠预防PEP安全、有效。Objective To investigate the safety and efficacy of Chai Shao Chengqi Decoction in preserving pancreatitis （ PEP ） . Methods A total of 158 patients with ERCP from June 2014 to September 2016 were randomly divided into 64 cases of traditional Chinese medicine group and 64 cases of western medicine group and 30 cases of control group.Endoscopic nasobiliary drainage （ ENBD ） was performed in the control group,and the third generation cephalosporin were applied to maintain water and electrolyte balance.On the basis of the control group, the traditional Chinese medicine group kept the enema while the western medicine group was given indometacin by 0.1 in 30 min after ERCP.The content of serum amylase were examined and the presence of gastrointestinal bleeding, heart failure, kidney damage and other complications before and after ERCP and 3h and 24h were observed in three groups. Results The treatment group could achieve the aim of preventing PEP and PEH, but the rate of PEP and PEH in traditional Chinese medicine was lower than that in western medicine group （ P〈0.05 ） . None of kidney damage, heart failure, bleeding complications was occurred in the traditional Chinese medicine group and the postoperative bleeding in traditional Chinese medicine group was significantly lower than that in western medicine group （ P〈0.05 ） . Conclusion It is safe and effective to keep PEP in the enema with Chai Shao Chengqi Decoction.

关 键 词：ERCP术后胰腺炎 中药 预防 

分 类 号：R657.4[医药卫生—外科学]