术前吲哚美辛塞肛联合术中生长抑素泵入预防ERCP术后胰腺炎的临床研究  

Clinical Study of Preoperative Indomethacin Plugging Anus Combined with Intraoperative Somatostatin Pumping in Preventing Post-ERCP Pancreatitis

作　　者：苏颖 SU Ying(Wuming Hospital of Guangxi Medical University,Nanning 530199,China)

机构地区：[1]广西医科大学附属武鸣医院,广西南宁530199

出　　处：《中外医学研究》2022年第1期60-63,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究术前吲哚美辛塞肛联合术中生长抑素泵入预防经内镜逆行性胰胆管造影术(ERCP)术后胰腺炎(PEP)的临床效果。方法:选取2019年1月-2020年12月广西医科大学附属武鸣医院100例拟行ERCP手术的患者,按随机数字表法将患者随机分为A组和B组,每组50例。A组术中使用生长抑素泵入,B组术前使用吲哚美辛塞肛联合术中生长抑素泵入。比较两组术前和术后24 h的外周血指标水平[血清脂肪酶(LPS)、血清淀粉酶、血清胰蛋白酶原-2]、肝功能[总胆红素(TBIL)、直接胆红素(DBIL)、碱性磷酸酶(ALP)、天门冬氨基转移酶(AST)]、炎症因子水平[白细胞计数(WBC)、血小板活化因子、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)];比较两组手术并发症发生情况。结果:术前,两组LPS、血清淀粉酶、血清胰蛋白酶原-2、TBIL、DBIL、ALP、AST、WBC、血小板活化因子、CRP、IL-6、IL-10水平比较,差异均无统计学意义(P>0.05);术后24 h,两组LPS、血清淀粉酶、血清胰蛋白酶原-2、WBC、血小板活化因子、CRP、IL-6、IL-10水平均高于术前,但B组均低于A组,差异均有统计学意义(P<0.05)。术后24 h,两组TBIL、DBIL、ALP、AST水平与术前比较,差异均无统计学意义(P>0.05)。术后24 h,两组TBIL、DBIL、ALP、AST水平比较,差异均无统计学意义(P>0.05)。B组PEP发生率低于A组,差异有统计学意义(P<0.05)。B组胆道感染、消化道出血发生率均低于A组,但差异均无统计学意义(P>0.05)。结论:术前吲哚美辛塞肛联合术中生长抑素泵入用于ERCP手术患者可有效预防术后PEP发生,且不影响患者肝功能,有利于患者术后恢复。Objective:To study the clinical effect of preoperative Indomethacin plugging anus combined with intraoperative Somatostatin pumping in preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).Method:A total of 100 patients who planned to undergo ERCP surgery in Wuming Hospital of Guangxi Medical University from January 2019 to December 2020 were selected,they were divided into group A and group B according to random number table,50 cases in each group.Group A was injected with Somatostatin pump during surgery,and group B was injected with Indomethacin with Somatostatin pump before surgery.The levels of peripheral blood indexes[serum lipase (LPS),serum amylase,serum trypsinogen 2],liver function[total bilirubin (TBIL),direct bilirubin (DBIL),alkaline phosphatase (ALP),aspartame aminotransferase (AST)]and inflammatory factors[white blood cell count (WBC),platelet activating factor,C-reactive protein (CRP),interleukin-6 (IL-6),interleukin-10 (IL-10)]before and 24 h after surgery were compared between two groups;the incidence of surgical complications was compared between two groups.Result:Before surgery,there were no significant differences in the levels of LPS,serum amylase,serum trypsinogen 2,TBIL,DBIL,ALP,AST,WBC,platelet activating factor,CRP,IL-6 and IL-10 between two groups (P>0.05).At 24 h after surgery,the levels of LPS,serum amylase,serum trypsinogen-2,WBC,platelet activating factor,CRP,IL-6 and IL-10 in both groups were higher than those before surgery,but those in the group B were lower than those in the group A,the differences were statistically significant (P<0.05).24 h after surgery,there were no significant differences in TBIL,DBIL,ALP and AST levels between two groups compared with those before surgery (P>0.05).24 h after surgery,there were no significant differences in TBIL,DBIL,ALP and AST levels between two groups (P>0.05).The incidence of PEP complications in the group B was lower than that in the group A,the difference was statistically significant (P<0.05).The in

关 键 词：吲哚美辛 生长抑素 经内镜逆行性胰胆管造影术 ERCP术后胰腺炎 

分 类 号：R576[医药卫生—消化系统] R657.4[医药卫生—内科学] R657.5[医药卫生—临床医学]