本文選題：加貝酯 + ERCP��； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：觀察加貝酯在不同時期應(yīng)用對預(yù)防ERCP術(shù)后高淀粉酶血癥及ERCP術(shù)后胰腺炎的療效。 方法：將381例行ERCP的膽胰疾病患者根據(jù)加貝酯的不同應(yīng)用時期分為四組，，分別為術(shù)前組（88例）、術(shù)后組（97例）、完全組（101例）及對照組（95例）。術(shù)前組、術(shù)后組及完全組均為用藥組，術(shù)前組在ERCP術(shù)前6小時內(nèi)予以加貝酯600毫克+0.9%NaCL注射液500毫升靜脈滴注；術(shù)后組在術(shù)后12小時內(nèi)予以加貝酯600毫克+0.9%NaCL注射液500毫升靜脈滴注；完全組在ERCP術(shù)前6小時開始予以加貝酯600毫克+0.9%NaCL注射液500毫升靜脈滴注，并于術(shù)后12小時內(nèi)再予以加貝酯600毫克+0.9%NaCL注射液500毫升靜脈滴注，對照組僅予以靜脈滴注0.9%NaCL注射液500毫升。ERCP術(shù)后24小時，測血清淀粉酶，同時觀察有無持續(xù)腹痛、發(fā)熱、嘔吐等表現(xiàn)。 結(jié)果：術(shù)后24小時血清淀粉酶水平：各用藥組較對照組顯著降低（P0.05）；ERCP術(shù)前組、術(shù)后組、完全組及對照組，術(shù)后高淀粉酶血癥的發(fā)生率分別為28.41%、26.80%、15.84%、46.32%，急性胰腺炎的發(fā)生率分別為3.41%、3.09%、1.98%、9.47%，用藥組各組術(shù)后高淀粉酶血癥及胰腺炎發(fā)生率較對照組顯著降低，差異有統(tǒng)計學(xué)意義（P0.05）；完全組術(shù)后24小時血清淀粉酶水平及高淀粉酶血癥發(fā)生率均顯著低于術(shù)前組、術(shù)后組，差異有統(tǒng)計學(xué)意義（P0.05），但三組間術(shù)后胰腺炎發(fā)生率無顯著差異（P0.05）。 結(jié)論：甲磺酸加貝酯能有效降低ERCP術(shù)后血清淀粉酶水平，能夠預(yù)防術(shù)后高淀粉酶血癥及術(shù)后胰腺炎的發(fā)生；推薦加貝酯的應(yīng)用方式為，ERCP術(shù)前6小時600毫克靜脈滴注，術(shù)后12小時內(nèi)600毫克靜脈滴注。
[Abstract]:Aim: to observe the effect of Gabexin in preventing hyperamylase and pancreatitis after ERCP. Methods: 381 patients with cholangiopancreatic diseases were divided into four groups according to different periods of application of Gabexate: preoperative group (88 cases), postoperative group (97 cases), complete group (101 cases) and control group (95 cases). The preoperative group, the postoperative group and the complete group were all treated with drugs. The preoperative group was given 600 mg of gabel 600 mg and 500 ml intravenous drip of 0.9 NaCL injection within 6 hours before ERCP. Within 12 hours after the operation, the patients in the postoperative group were given 600 mg of gabelate 600 mg and 500 ml intravenous drip of 0.9 NaCL injection, and the complete group received 600 mg 0.9 NaCL injection 500 ml intravenous drip beginning 6 hours before ERCP. Within 12 hours after operation, the patients in the control group were given 500 ml intravenous drip of 0.9NaCL injection with 600 mg Gabecyl ester, while the control group was only given 500 ml of 0.9 NaCL injection. The serum amylase was measured 24 hours after the operation, and the continuous abdominal pain and fever were observed. Vomiting, etc Results: 24 hours after operation, the serum amylase levels in each medication group were significantly lower than those in the control group (P0.05), the preoperative group, the postoperative group, the complete group and the control group were significantly lower than those in the control group. The incidence of postoperative hyperamylase and acute pancreatitis were 28.41, 26.80 and 46.32, respectively. The incidence of acute pancreatitis was 3.41 and 3.090.98 respectively. The incidence of hyperamylase and pancreatitis in the treatment group was significantly lower than that in the control group (P0.05). The levels of serum amylase and the incidence of hyperamylase in the complete group 24 hours after operation were significantly lower than those in the preoperative group (P0.05), but there was no significant difference in the incidence of postoperative pancreatitis among the three groups (P0.05). Conclusion: Gabecyl mesylate can effectively reduce the level of serum amylase after ERCP and prevent the occurrence of postoperative hyperamylase and postoperative pancreatitis. 600 mg intravenous drip was given within 12 hours after operation.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R576

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