生长抑素联合吲哚美辛栓剂降低胆管癌ERCP术后胰腺炎发生率的效果研究  

Effect of somatostatin combined with indomethacin suppository on the incidence of pancreatitis after ERCP for cholangiocarcinoma

作　　者：张培建[1] 刘孟东 刘科霞[1] 王雅琪 刘旭光 ZHANG Pei-jian;LIU Meng-dong;LIU Ke-xia;WANG Ya-qi;LIU Xu-guang(Endoscopy Unit, Department of General Surgery, Cangzhou Central Hospital, Hebei Province, Cangzhou 061000, China;Department of Pain Management, People′s Hospital of Cangzhou, Hebei Province, Cangzhou 061000,China;Department of Traditional Chinese Medicine, Cangzhou Central Hospital, Hebei Province, Cangzhou 061000, China;Department of Neurosurgery, Cangzhou Central Hospital, Hebei Province, Cangzhou 061000, China)

机构地区：[1]河北省沧州市中心医院普外科内镜,河北沧州061000 [2]河北省沧州市人民医院疼痛科,河北沧州061000 [3]河北省沧州市中心医院中医科,河北沧州061000 [4]河北省沧州市中心医院神经外科,河北沧州061000

出　　处：《河北医科大学学报》2021年第3期298-303,共6页Journal of Hebei Medical University

基　　金：沧州市重点研发计划指导项目(204106097)。

摘　　要：目的研究生长抑素联合吲哚美辛栓剂降低胆管癌内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)后胰腺炎发生率的效果。方法随机选择行ERCP治疗的胆管癌患者280例作为研究对象。按随机数字表法平均分为4组,每组70例。所有患者行ERCP。A组患者给予生长抑素,B组患者给予吲哚美辛栓剂,C组患者给予生长抑素联合吲哚美辛栓剂,D组为未应用上述措施。比较四组患者ERCP术后急性胰腺炎、高淀粉酶血症发生率,以及术后5 h、24 h患者的血清淀粉酶(amylase,AMS)、脂肪酶(lipase,LPS)、白细胞(white blood cell,WBC)等相关指标水平。结果A、B、C组患者术后胰腺炎发生率均低于D组(P<0.05),C组发生率低于A组及B组(P<0.05),A、B组发生率差异无统计学意义(P>0.05)。四组患者两两相比,高淀粉酶血症的发生率A、B、C组之间差异均无统计学意义(P>0.05),但均低于D组。AMS与LPS两指标均是术前A、B、C、D四组间比较差异无统计学意义(P>0.05);术后5 h和24 h,A、B两组比较差异均无统计学意义(P>0.05),其余任意两组比较差异均有统计学意义(P<0.05),即AMS与LPS两指标A、B、C组水平均低于D组,C组水平均低于A、B组;WBC指标术前和术后5 h,A、B、C、D四组间比较差异均无统计学意义(P>0.05);术后24 h,A、B两组比较差异均无统计学意义(P>0.05),其余任意两组比较差异均有统计学意义(P<0.05),即A、B、C组WBC水平均低于D组,C组WBC水平均低于A、B组。结论生长抑素联合吲哚美辛栓剂对于降低胆管癌ERCP术后胰腺炎的发生率效果显著。Objective To study the effect of somatostatin combined with indomethacin suppository in reducing the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP)for cholangiocarcinoma.Methods A total of 160 patients with cholangiocarcinoma treated by ERCP were randomly selected as the study subjects,and divided into four groups according to random number table method,with 70 patients in each group.ERCP was performed in all patients.Group A was given somatostatin,group B was given indomethacin,group C was given somatostatin combined with indomethacin,and group D did not receive any of the above treatment.The incidence of acute pancreatitis and hyperamylaseemia after ERCP,as well as the levels of serum amylase(AMS),lipase(LPS)and white blood cell(WBC)at 5 h and 24 h after operation,was compared among the four groups.Results The incidence of postoperative pancreatitis in groups A,B and C was lower than that in group D(P<0.05),and the incidence in group C was lower than that in groups A and B(P<0.05).There was no statistical significance in the incidence between groups A and B(P>0.05).No significant difference was noted in the incidence of hyperamylasemia among groups A,B and C(P>0.05),which,however,was lower than that in group D.There was no statistical significance in both AMS and LPS among groups A,B,C and D before surgery(P>0.05).At 5 h and 24 h after operation,there were no statistically significant differences between group A and B(P>0.05);there were statistically significant differences between any other two groups(P<0.05),that is,the levels of AMS and LPS in groups A,B and C were lower than those in group D,while the levels in group C were lower than those in group A and B.There was no significant difference in WBC indexes between groups A,B,C and D before and at 5 h after operation(P>0.05).At 24 h after surgery,there was no statistically significant difference between group A and group B(P>0.05);there was statistically significant difference between any other two groups(P<0.05),that i

关 键 词：胆管肿瘤 生长抑素 吲哚美辛 胰胆管造影术 内窥镜逆行 

分 类 号：R735.8[医药卫生—肿瘤]