吲哚美辛联合生长抑素对ERCP术后胰腺炎的预防作用

目的:研究吲哚美辛联合生长抑素对内镜逆行胰胆管造影(ERCP)术后胰腺炎的预防作用及对血清淀粉酶的影响。方法:选取2015年7月至2016年6月在我院行ERCP术的患者共72例,根据随机数字法分为观察和对照组,每组36例。对照组在术前使用生长抑素完成治疗,观察组在此基础上联合吲哚美辛栓剂完成治疗。分析和比较两组患者ERCP术后5、10、24、48h的血清淀粉酶水平,ERCP术后48h胰腺炎的发生率、肝功能变化情况和临床症状改善情况。结果:术前,两组患者血清淀粉酶水平比较无显著差异(P0.05),术后5h,两组患者的血清淀粉酶水平较高,和术后5h相比,两组术后10、24、48h的血清淀粉酶水平明显降低(P0.05),但观察组各时点血清淀粉酶水平均低于对照组(P0.05)。术前,两组患者GGT、ALP、AST水平比较无显著差异(P0.05),术后48h,两组患者GGT、ALP、AST水平较术前无明显变化(P0.05)。术后48 h,观察组的胰腺炎发生率显著低于对照组8.33%(3/36) vs. 36.11%(13/36)](P0.05)。观察组的皮肤瘙痒、腹泻、恶心、厌食、感染的减轻率均高于对照组(P0.05)。结论:吲哚美辛联合生长抑素能有效降低ERCP术后胰腺炎的发生率,降低血清淀粉酶水平。

Preventive Effect of Indomethacin and Somatostatin on the Pancreatitis after ERCP

ABSTRACT Objective: To study the effect of indomethacin and somatostatin on the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) and its effect on serum amylase. Methods: A total of 72 patients with ERCP were selected from July 2015 to June 2016 in our hospital. According to the random number method, those patients were divided into observation group and control group, 36 cases in each group. The control group was treated with somatostatin before surgery, and the observation group was treated with indomethacin suppository on the basis of control group. The levels of serum amylase were analyzed at 5h, 10h, 24h after operation and 48 hours after operation. The incidence of pancreatitis after ERCP was compared between the two groups. Observe the change of liver function and the improvement of clinical symptoms in both groups. Results: Before operation, serum amylase level between the two groups had no difference(P>0.05), serum amylase level was higher in the two groups after 5 hours postoperation, and the levels of serum amylase were decreased in the two groups (P <0.05), but the observation group was always lower than the control group (P <0.05). Before surgery, there was no significant difference in GGT, ALP and AST levels between the two groups (P>0.05). At 48 hours after operation, GGT, ALP, and AST levels did not change significantly (P>0.05). There was no significant difference in GGT, ALP and AST levels in the control group (P>0.05). The incidence of pancreatitis in the observation group was significantly lower than that in the control group 8.33% (3/36) vs 36.11% (13/36)] (x2=8.036, P <0.05). The skin pruritus, diarrhea, nausea, anorexia, and infection reduction rate in the observation group were higher than those in the control group (P<0.05). Conclusion: Indomethacin combined with somatostatin can effectively reduce the incidence of pancreatitis after ERCP, and then decrease the level of serum amylase.