胆宁片预防胆总管结石ERCP术后胰腺炎、高淀粉酶血症的临床疗效研究  

Clinical efficacy of Danning tablets in preventing pancreatitis and hyperamy-lasemia after ERCP for choledocholithiasis

作　　者：朱宝成 ZHU Bao-cheng(Department of General Surgery,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan Uni-versity,Shanghai 201799,China)

机构地区：[1]复旦大学附属中山医院青浦分院普外科,上海201799

出　　处：《哈尔滨医科大学学报》2024年第6期665-670,共6页Journal of Harbin Medical University

基　　金：上海市中西医结合学会社区医学与健康管理研究项目(2021-44)。

摘　　要：目的 研究口服胆宁片在预防内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)后引发的胰腺炎(post-ERCP pancreatitis, PEP)和高淀粉酶血症(post-ERCP hyperamylasemia, PEH)中的临床效果。方法 选取2022年1月~2023年12月在复旦大学附属中山医院青浦分院进行ERCP治疗的90例患者,随机分为治疗组(45例)和对照组(45例)。两组患者均进行常规治疗,治疗组术前6 h口服胆宁片,术后麻醉清醒后及术后6 h各口服1次,治疗疗程7 d。对照组仅术前0.5 h吲哚美辛栓纳肛。观察两组患者的临床疗效、腹痛症状、PEP、PEH发病情况及炎症指标水平变化。结果 治疗组在缩短住院时间及降低住院费用方面与对照组比较具有优势,但差异无统计学意义(P>0.05)。手术后,两组患者的腹痛视觉模拟量表(visual analogue scale for abdominal pain, VAS-AP)评分在术后第1 d和术后第4 d较治疗前均明显降低,且治疗组患者于术后第1 d的VAS评分低于对照组,差异有统计学意义(P<0.05)。治疗组患者总有效率为93.33%(42/45),高于对照组的84.44%(38/45),差异有统计学意义(P<0.05)。术后治疗组PEP和PEH发生率与对照组差异无统计学意义(P>0.05)。手术后,两组患者术后第1 d和术后第4 d的白细胞、中性粒细胞、降钙素原(procalcitonin, PCT)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、C反应蛋白(c-reactive protein, CRP)、白介素-6(interleukin-6,IL-6)和白介素-8(interleukin-8,IL-8)水平较术前均明显降低,白介素-10(interleukin-10,IL-10)水平较治疗前升高,差异均有统计学意义(P<0.05)。术后第1 d,治疗组患者的白细胞、中性粒细胞、PCT、TNF-α、CRP水平均明显低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05);术后第4 d,治疗组患者血清白细胞、中性粒细胞、PCT、TNF-α和CRP水平均低于对照组,IL-10水平高于对照组,差异有统计学意义(P<0.05)。结论 连续口服胆宁�Objective To study the clinical effect of oral Danning tablets in the prevention of post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP)and post-ER-CP hyperamylasemia(PEH).Methods A total of 90 patients who underwent ERCP treatment at the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January 2022 to December 2023 were selected and randomly divided into a treatment group(45 cases)and a control group(45 cases).Both groups of patients received conventional treatment.The treat-ment group took Danning tablets orally 6 hours before surgery,once after awakening from anes-thesia and 6 hours after surgery,and the treatment course was 7 days.The control group only took indomethacin suppositories in the rectum 0.5 hours before surgery.The clinical efficacy,abdominal pain symptoms,PEP,PEH incidence,and changes in inflammatory index levels of the two groups of patients were observed.Results Compared with the control group,the treat-ment group had advantages in shortening the length of hospital stay and reducing the cost of hospitalization,but the difference was not statistically significant(P>0.05).After surgery,the visual analogue scale for abdominal pain(VAS-AP)in both groups were significantly lower than those before treatment on the first and fourth days after surgery,and the VAS scores of the treatment group were lower than those of the control group on the first days after surgery,and the differences were statistically significant(P<0.05).The total effective rate of the treatment group was 93.33%(42/45),which was higher than 84.44%(38/45)in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of PEP and PEH between the treatment group and the control group(P>0.05).After surgery,the levels of white blood cells,neutrophils,procalcitonin(PCT),tumor necrosis factor-α(TNF-α),c-reactive protein(CRP),interleukin-6(IL-6),and interleukin-8(IL-8)in the two groups of patients on the first and fourth days aft

关 键 词：内镜下逆行胰胆管造影术 胰腺炎 高淀粉酶血症 胆宁片 疗效分析 

分 类 号：R657.4[医药卫生—外科学]