直肠应用吲哚美辛在预防ERCP术后胰腺炎中作用地研究.pdfVIP

  直肠应用吲哚美辛在预防ERCP 术后 胰腺炎中作用的研究 季涛，鲁临，徐向明，谭洪武，徐启苗 临沂市人民医院消化一科，山东 临沂 276003 【摘要】目的 观察直肠应用吲哚美辛对 ERCP 术后胰腺炎(PEP)及高淀粉酶血症的预防作用。 方法 将行 ERCP 检查的 60 例患者随机分为吲哚美辛组和对照组，吲哚美辛组在 ERCP 术前 60min 直肠内给予吲哚美辛栓剂 100mg，对照组在 ERCP 术前不予直肠内治疗。ERCP 术后观察患者有无 腹痛，并于术后 4h 、24h 及 48h 做血清淀粉酶测定。结果 吲哚美辛组 PEP 发生率(0 ％)与对照组 PEP 发生率(6.7 ％)无统计学差异（P0.05 ），但吲哚美辛组 ERCP 术后高淀粉酶血症发生率(23.3 ％) 显著低于对照组(60 ％，P0.01) 。结论 直肠应用吲哚美辛可以预防 ERCP 术后高淀粉酶血症的发生。 【关键词】内窥镜逆行性胰胆管造影术；胰腺炎；吲哚美辛 中图分类号：R576 Rectal indomethacin for prevention of post-ERCP pancreatitis JI tao ，LU lin Department of Gastroenterology ，Linyi People，s Hospital，Shandong，Linyi 276003 【Abstract 】 Objective To investigate the effect of prophylactic rectal indomethacin on post-ERCP hyperamylasemia and pancreatitis. Methods Sixty patients who underwent ERCP for various reasons were randomly divided into indomethacin group and control group. Rectal indomethacin (100mg) was administered to indomethacin group prior to ERCP. Serum amylase level was measured at 4, 24, 48 hours after the procedure. Results The incidence of post-ERCP pancreatitis (PEP) in the indomethacin group was 0 ％ and 6.7 ％ in the control group.This difference was not statistically siginificant (P0.05) . The incidence of post-ERCP hyperamylasemia in the indomethacin group (23.3 ％) was much lower than that in control group (60 ％, P0.01). Conclusion Rectal indomethacin can prevent hyperamylasemia induced by ERCP. 【Key words 】 Endoscopic rectrograde cholangiopancreatography; Pancreatitis; Indomethacin 内镜下逆行性胰胆管造影术(ERCP)是胰胆管疾病重要的诊断和治疗方法，尤其是治疗性 ERCP 在胰胆管的微创治疗中占有越来越重要的地位[1] 。但无论是诊断性还是治疗性ERCP ，均可出现一些 难以避免的并发症，如 ERCP 后胰腺炎(post-ERCP pancreatitis，PEP) 、高淀粉酶血症、出血及穿孔 等，尤其是 P