【摘要】：目的:評估生大黃浸泡液預(yù)防ERCP術(shù)后胰腺炎(PEP)及高淀粉酶血癥的療效。方法:從2012年10月至2013年10月,共有500例高�；颊弑浑S機(jī)分入生大黃組(250例)和對照組(250例),術(shù)后均予常規(guī)治療外,生大黃組于ERCP術(shù)后(q3h)服用生大黃浸泡液(統(tǒng)一來源的生大黃每次50g開水泡水10min)至通便為止。兩組均檢測術(shù)后24小時血常規(guī)、肝功能等。觀察患者術(shù)后的癥狀(如腹痛、腹脹等)及通便時間。結(jié)果:兩組在患者人口統(tǒng)計特征、病史、ERCP流程、患者相關(guān)以及手術(shù)相關(guān)的高風(fēng)險因素等方面無明顯差異。在250例服用生大黃的患者中有5(2%)例出現(xiàn)了PEP,對照組的250位患者中有19(7.6%)例患者出現(xiàn)PEP,兩組間差異有顯著性意義(P=0.003);ERCP術(shù)后高淀粉酶血癥在生大黃組和對照組的發(fā)生率分別為5.2%(13/250)和16.8%(42/250),生大黃組明顯低于對照組(P0.01)。生大黃組中重度PEP例數(shù)明顯少于對照組,但無統(tǒng)計學(xué)意義(P0.05)。生大黃組的術(shù)后腹痛發(fā)生率也明顯低于對照組(P0.01),但腹痛程度無統(tǒng)計學(xué)意義(P0.05)。兩組在ERCP術(shù)前白細(xì)胞、血清總膽紅素、谷丙轉(zhuǎn)氨酶水平?jīng)]有明顯差異,術(shù)后白細(xì)胞、谷丙轉(zhuǎn)氨酶和血清總膽紅素水平變化均無顯著性意義(P0.05)。結(jié)論:生大黃可降低高危患者PEP及高淀粉酶血癥的發(fā)生率,減輕術(shù)后腹痛的發(fā)生率。
[Abstract]:Objective: to evaluate the effect of rhubarb soaking solution on prevention of (PEP) and hyperamylemia in patients with post-ERCP pancreatitis. Methods: from October 2012 to October 2013, a total of 500 high-risk patients were randomly divided into the rhubarb group (250 cases) and the control group (250 cases). The rhubarb group was treated with rhubarb soaking solution (50 g boiling water 10min per time) after ERCP (Q 3 h) until defecation. Blood routine and liver function were measured 24 hours after operation in both groups. The postoperative symptoms (such as abdominal pain, abdominal distension, etc.) and the duration of defecation were observed. Results: there was no significant difference in demographic characteristics, history, ERCP process, patient-related and surgical-related high risk factors between the two groups. Among the 250 patients who took rhubarb, 5 (2%) had PEP, control group, 19 (7.6%) patients had PEP, (P < 0.05), and there was a significant difference between the two groups (P < 0.05). The incidence of hyperamylase in rhubarb group and control group after ERCP was 5.2% (13 / 250) and 16.8% (42 / 250), respectively. The incidence of hyperamylase in rhubarb group was significantly lower than that in control group (P0.01). The number of moderate and severe PEP cases in rhubarb group was significantly lower than that in control group, but there was no statistical significance (P0.05). The incidence of postoperative abdominal pain in rhubarb group was significantly lower than that in control group (P0.01), but the degree of abdominal pain had no statistical significance (P0.05). There was no significant difference in the levels of leukocyte, serum total bilirubin and glutamic pyruvic transaminase between the two groups before ERCP, but there was no significant difference in the levels of leucocyte, glutamic pyruvic transaminase and serum total bilirubin after operation (P0.05). Conclusion: rhubarb can reduce the incidence of PEP and hyperamylase in high risk patients and relieve the incidence of postoperative abdominal pain.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R576

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