生长抑素对不同风险ERCP患者术后胰腺炎的预防作用的影响  

The Effect of Somatostatin on the Prevention of Postoperative Pancreatitis in Patients with Different Risk ERCP

作　　者：王爱萍 王桂良 龚敏 邱萍 徐林芳 李兴 WANG Aiping;WANG Guiliang;GONG Min;QIU Ping;XU Linfang;LI Xing(Gannan Medical University,Ganzhou 341000,Jiangxi,China;Department of Digestion,Pingxiang Hospital Affiliated to Gannan Medical University,Pingxiang 337000,Jiangxi,China)

机构地区：[1]赣南医科大学,江西赣州341000 [2]赣南医科大学附属萍乡医院消化内科,江西萍乡337000

出　　处：《系统医学》2025年第5期20-27,共8页Systems Medicine

基　　金：江西省卫生健康委科技计划课题(20204374)。

摘　　要：目的探讨对于不同风险的经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术后胰腺炎(post-ERCP pancreatitis,PEP)患者,使用生长抑素对其预防作用的影响。方法非随机选取赣南医科大学附属萍乡医院2017年1月—2022年10月行ERCP术的1657例患者为研究对象,按随机数字表法分为两组,高风险PEP组(n=1011,其中空白对照组480例,生长抑素组531例)和低风险PEP组(n=646,其中空白对照组282例,生长抑素组326例)。分析4组插管成功率、非困难插管成功率、高淀粉酶血症及PEP发生率、插管时间、插管次数、住院时间、术中出血量、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin 6,IL-6)、白细胞介素8(interleukin 8,IL-8)水平、并发症发生情况和不良反应发生情况。结果高风险PEP组中,与空白对照组比较,生长抑素组插管成功率升高、非困难插管成功率升高、高淀粉酶血症发生率降低、PEP发生率降低、插管时间减少、插管次数减少、住院时间缩短、出血量降低、出血发生率降低、穿孔发生率降低,差异有统计学意义(P均<0.05)。低风险PEP组中,与空白对照组比较,生长抑素组插管成功率升高、非困难插管成功率升高,插管时间减少、插管次数减少,差异有统计学意义(P均<0.05);两组高淀粉酶血症发生率、PEP发生率、住院时间对比,差异无统计学意义(P均>0.05)。治疗方法和时间对高风险和低风险PEP组患者炎症因子水平均存在协同作用,不同风险组炎症因子水平比较,生长抑素组术后6、12和24 h炎症因子水平较空白对照组均降低,差异有统计学意义(P均<0.05)。在高风险PEP组中,与空白对照组相比,生长抑素组的并发症发生率降低,不良反应发生率增加,差异有统计学意义(P均<0.05)。低风险PEP两组均未出现并发症。在低风险PEP组中,生长抑素组不良反应发生率高于空白对照组,差�Objective To investigate the effect of somatostatin on the prevention of post-ERCP pancreatitis(PEP)in patients with different risks after endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 1657 patients who underwent ERCP in Pingxiang Hospital Affiliated to Gannan Medical University from January 2017 to October 2022 were non-randomly divided into two groups according to the random number table method:high-risk PEP group(n=1011,including 480 cases in blank control group and 531 cases in somatostatin group)and low-risk PEP group(n=646,including 282 cases in blank control group and 326 cases in somatostatin group).The success rate of intubation,the success rate of non-difficult intubation,the incidence of hyperamylasemia and PEP,intubation time,intubation times,hospitalization time,intraoperative blood loss,tumor necrosis factor-α(TNF-α),interleukin 6(IL-6),interleukin 8(IL-8)levels,complications and adverse reactions were analyzed in the four groups.Results In the high-risk PEP group,compared with the blank control group,the success rate of intubation increased,the success rate of non-difficult intubation increased,the incidence of hyperamylasemia decreased,the incidence of PEP decreased,the intubation time decreased,the number of intubations decreased,the hospitalization time shortened,the amount of bleeding decreased,the incidence of bleeding decreased,and the incidence of perforation decreased in the somatostatin group,and the differences was statistically significant(all P<0.05).In the low-risk PEP group,compared with the blank control group,the success rate of intubation in the somatostatin group increased,the success rate of nondifficult intubation increased,the intubation time decreased,and the number of intubations decreased,the differences were statistically significant(all P<0.05);there were no significant differences in the incidence of hyperamylasemia,PEP and hospitalization time between the two groups(all P>0.05).The treatment method and time had a synergistic effect on the leve

关 键 词：内镜逆行胰胆管造影术 生长抑素 ERCP术后胰腺炎 

分 类 号：R576[医药卫生—消化系统]