【摘要】：目的探討低分子右旋糖酐聯(lián)合吲哚美辛栓劑對(duì)內(nèi)鏡逆行胰膽管造影術(shù)(ERCP)后胰腺炎的預(yù)防作用。方法 215例至少具備一項(xiàng)ERCP術(shù)后胰腺炎高危因素的患者術(shù)前隨機(jī)分為四組。對(duì)照組(n=51)給予氯化鈉注射液+安慰劑,吲哚美辛組(n=54)給予氯化鈉注射液+吲哚美辛栓劑(術(shù)前單次經(jīng)直腸給藥50 mg),低分子右旋糖酐組(n=52)給予低分子右旋糖酐(術(shù)前單次靜脈輸注500 m L)+安慰劑,藥物聯(lián)用組(n=58)給予低分子右旋糖酐(術(shù)前單次靜脈輸注500 m L)+吲哚美辛栓劑(術(shù)前單次經(jīng)直腸給藥50 mg)。觀察術(shù)后胰腺炎發(fā)生率、重癥急性胰腺炎發(fā)生率及患者死亡率,記錄住院時(shí)間。結(jié)果對(duì)照組、吲哚美辛組、低分子右旋糖酐組和藥物聯(lián)用組胰腺炎發(fā)生率分別為24%、15%、14%和5%,藥物聯(lián)用組ERCP術(shù)后胰腺炎發(fā)生率低于對(duì)照組(P0.01);四組患者重癥胰腺炎發(fā)生率以及死亡率無(wú)顯著差異(P0.05)。對(duì)照組、吲哚美辛組、低分子右旋糖酐組和藥物聯(lián)用組平均住院時(shí)間分別為(5.8±2.9)、(5.2±1.9)、(6.1±2.5)和(4.3±2.0)d,與其他三組相比,藥物聯(lián)用組術(shù)后平均住院時(shí)間縮短(P0.05)。結(jié)論低分子右旋糖酐聯(lián)合吲哚美辛栓劑對(duì)于ERCP術(shù)后胰腺炎有較好的預(yù)防作用。
[Abstract]:Objective to investigate the preventive effect of low molecular dextran and indomethacin suppository on pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). Methods 215 patients with at least one risk factor of pancreatitis after ERCP were randomly divided into four groups. The control group (nf51) was given a placebo of sodium chloride injection. Indomethacin group (nnt54) was treated with sodium chloride injection indomethacin suppository (50 mg), before rectal administration) and low-molecular-weight dextran group (nf52) with low molecular weight dextran (500ml intravenously before operation) as a placebo. The combined drug group (nong58) was given low-molecular-weight dextran (500ml intravenously before operation) with indomethacin suppository (50 mg). Before single transrectal administration). The incidence of postoperative pancreatitis, the incidence of severe acute pancreatitis and the mortality of patients were observed, and the hospitalization time was recorded. Results the control group, indomethacin group, The incidence of pancreatitis in the low molecular dextran group and the combined drug group was 24 15% and 5%, respectively. The incidence of ERCP postoperative pancreatitis in the combined drug group was lower than that in the control group (P0.01), but there was no significant difference in the incidence and mortality of severe pancreatitis among the four groups (P0.05). The average hospitalization time of control group, indomethacin group, low molecular weight dextran group and drug combination group were (5.8 鹵2.9), (5.2 鹵1.9), (6.1 鹵2.5) days and (4.3 鹵2.0) days, respectively. Compared with the other three groups, the average hospitalization time of the combined drug group was shorter than that of the other three groups (P0.05). Conclusion low-molecular dextran combined with indomethacin suppository can prevent pancreatitis after ERCP.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院第一分院消化內(nèi)科;重慶醫(yī)科大學(xué)附屬第一醫(yī)院消化內(nèi)科;
【分類號(hào)】：R576

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