胰管支架及奧曲肽預防ERCP術后胰腺炎的研究

張璋　梁彪　陳禮婷　黃學勤

【摘要】 目的：探討胰管支架及奧曲肽預防內鏡逆行胰膽管造影（ERCP）術后胰腺炎的效果。方法：選擇2015年6月-2017年5月本院收治的采取診治性ERCP的無胰腺炎高危患者80例作為研究對象，患者均愿意接受本研究，根據處理方式不同分為胰管支架組（28例）、奧曲肽組（30例）、對照組（22例），分別采取胰管支架、奧曲肽及氯化鈉溶液預防胰腺炎。觀察與記錄三組術后胰腺炎發生率、高淀粉酶血癥發生率、PCT降至正常時間、住院時間、住院費用，并采取統計學分析。結果：胰管支架組、奧曲肽組的術后胰腺炎發生率、高淀粉酶血癥發生率、PCT降至正常時間、住院時間、住院費用比較，差異均無統計學意義（P>0.05），但兩組以上指標均明顯優于對照組（P<0.05）。結論：胰管支架與奧曲肽預防ERCP術后胰腺炎有相似的效果，相比氯化鈉溶液處理可以更好地減少胰腺炎與高淀粉酶血癥發生，而且能縮短PCT降至正常時間與住院時間，減少住院費用，臨床應用時可合理選擇。

【關鍵詞】 ERCP； 胰腺炎； 高淀粉酶血癥； 胰管支架； 奧曲肽

Study of Pancreatic Stent and Octreotide in Prevention of Postoperative Pancreatitis after ERCP/ZHANG Zhang，LIANG Biao，CHEN Li-ting，et al.//Medical Innovation of China，2017，14（30）：044-047

【Abstract】 Objective：To investigate the effect of pancreatic duct stent and octreotide in prevention of postoperative pancreatitis after endoscopic retrograde cholangiopancreatography（ERCP）.Method：80 non-pancreatitis high risk patients who were taken diagnostic ERCP in our hospital from June 2015 to May 2017 were selected，all patients were willing to accept this study.According to the different treatment methods，they were divided into pancreatic duct stent group（28 cases），octreotide group（30 cases） and control group（22 cases），pancreatic stent，octreotide and saline were used to prevent pancreatitis respectively.The incidence of postoperative pancreatitis，the incidence of hyperamylasemia，the time of reduction of PCT to normal time，hospitalization time and hospitalization cost were observed and recorded，the statistical analysis was carried out.Result：The incidence of postoperative pancreatitis，the incidence of hyperamylasemia，the time of reduction of PCT to normal time，hospitalization time and hospitalization cost in pancreatic duct stent group and octreotide group were compared，the differences were not statistically significant（P>0.05），but both groups were significantly better than those of the control group（P<0.05）.Conclusion：Pancreatic tube stent and octreotide have similar effects on the prevention of pancreatitis after ERCP，compared with normal saline treatment，pancreatic duct can reduce the occurrence of pancreatitis and amylase and reduce the time of PCT to normal time and hospitalization，reduce the cost of hospitalization，clinical application can be a reasonable choice.

【Key words】 ERCP； Pancreatitis； Hyperamylasemia； Pancreatic tube stent； Octreotide

First-authors address：Peoples Hospital of Yunfu City，Yunfu 527300，China

doi：10.3969/j.issn.1674-4985.2017.30.013endprint

為了進一步探討胰管支架及奧曲肽預防內鏡逆行胰膽管造影術后胰腺炎的效果，本院將收治的診治性內鏡逆行胰膽管造影（ERCP）術的無胰腺炎高危患者80例作為研究對象，現報道如下。

1 資料與方法

1.1 一般資料 選擇2015年6月-2017年5月本院收治的采取診治性ERCP的無胰腺炎高危患者80例作為研究對象。納入標準：年齡>18歲，不限男女；確診且滿足ERCP指征，擬行該手術；術前血清淀粉酶水平正常；簽署知情同意書愿意配合研究。排除標準：嚴重心血管、肝臟、腎臟疾病，如腎功能不全或心肺功能不全；妊娠期或哺乳期；急性胰腺炎或慢性胰腺炎急性發作；造影劑過敏；嚴重膽道感染；奧曲肽或生長抑素類藥物禁忌證；精神障……