奥曲肽联合置入胰管支架对胆总管结石伴插管困难患者ERCP术后胰腺炎的预防作用

程珍

doi:10.3969/j.issn.1671-038X.2017.05.07

奥曲肽联合置入胰管支架对胆总管结石伴插管困难患者ERCP术后胰腺炎的预防作用

程珍^,

- 芜湖市第二人民医院消化内科, 安徽芜湖 241000

详细信息

作者简介:
程珍,女,本科,主治医师,主要从事消化内科的临床科研和教学工作

通讯作者: 程珍,E-mail:417282394@qq.com

中图分类号: R576

收稿日期: 2016-11-11

Prophylactic effect of Octreotide combined with pancreatic duct stent on postoperative pancreatitis in patients with biliary duct stones complicated with ERCP

CHENG Zhen^,

- Department of Gastroenterology, Wuhu Second People's Hospital, Anhui 241000, China

More Information

Corresponding author: CHENG Zhen, E-mail: 417282394@qq.com

Received Date: 11 November 2016

摘要

摘要: [目的]旨在探讨奥曲肽联合置入胰管支架预防胆总管结石伴插管困难患者ERCP术后胰腺炎的效果。[方法]选取本院内镜中心于2014年1月~2016年6月间收治行ERCP术胆总管结石伴插管困难患者50例作为研究对象，随机数字表法将患者分为观察组25例和对照组25例。行EPCP术后，对照组患者接受术后抑酸、抑酶、抗炎、补液、对症支持治疗，在此基础上，观察组患者接受术后静脉泵入奥曲肽注射和术中后置入胰管支架治疗。观察和比较2组患者症状消失时间、住院时间和治疗费用。观察和比较2组患者术后胰腺炎（PEP）、高淀粉酶血症发生情况。测定和比较2组患者术后3 h和术后24 h血清淀粉酶（AMS）表达、降钙素（PCT）和血清C反应蛋白（CRP）表达。[结果]对照组患者PEP发生率44%和高淀粉酶血症发生率28%明显高于观察组患者12%和4%，差异有统计学意义（P<0.05）。术后3 h，对照组患者血清AMS表达（1388±468） U/L明显高于观察组患者AMS表达（364±424） U/L，差异有统计学意义（P<0.05），2组患者PCT和CRP表达差异无统计学意义（P<0.05）；术后24 h，2组患者AMS表达差异无统计学意义（P>0.05），观察组患者PCT和CRP表达低于对照组患者，差异有统计学意义（P<0.05）。观察组患者治疗费用高于对照组患者，住院时间低于对照组患者，差异无统计学意义（P>0.05），症状消失时间低于对照组患者，差异有统计学意义（P<0.05）。[结论]奥曲肽联合置入胰管支架可显著降低胆总管结石伴插管困难患者ERCP术后PEP及高淀粉酶血症发生率，值得临床推广。
- 奥曲肽 /
- 胰管支架 /
- 胆总管结石 /
- 插管困难 /
- ERCP术后胰腺炎
Abstract: [Objective] To investigate the effect of Octreotide combined with pancreatic duct stent in the prevention of post-ERCP pancre-atitis in patients with common bile duct stones complicated with intubation.[Methods] 50 cases of patients with common bile duct stones and intubation difficulties who were treated by ERCP were selected as research objects during January 2014 to June 2016 in the Endoscopy center of our hospital.The patients were randomly divided into two groups:observation group(n=25) and control group(n=25).After EPCP surgery, control group were given anti-inflammatory, fluid infusion, symptomatic support therapy.On this basis, observation group were given postoperative Octreotide injection and pancreatic duct stent implantation.The symptoms disappearing time, hospitalization time and treatment costs were observed and compared between the two groups.The incidence of postoperative pancreatitis(PEP) and high amylase of two groups were observed and compared.The expression levels of serum amylase(AMS), calcitonin(PCT) and serum reactive protein(CRP) were measured and compared between the two groups after operation at 3 h and 24 h of post-ERCP.[Results] The incidence of PEP(44%) and the incidence of high amylase(28%) in the control group were significantly higher than that in the observation group(4% and 12%), and the difference was statistically significant(P<0.05).At 3 h of post-operation, control group's expression level of serum AMS(1388±68 U/L) was significantly higher than observation group's(364±424) U/L, and the difference was statistically significant(P<0.05).Two groups of patients's expression levels of PCT and CRP were not statistically different(P<0.05);At 24 h of post-operation, two groups of patients'AMS expressiom were not statistically different(P>0.05).Observation group's expression levels of PCT and CRP were significantly lower than control group's(P<0.05).The treatment cost of observation group was higher than that of the control group, the hospitalization time was lower than that of the control group, but difference was not statistically significant(P>0.05), the disappearance time of symptoms was lower than those of control group(P<0.05), the difference was statistically significant.[Conclusion] The incidence of PEP and high amylase in patients with common bile duct stones were significantly reduced by Octreotide combined with pancreatic duct stent, which is worthy of clinical application.
- Octreotide /
- pancreatic duct stent /
- common bile duct stones /
- difficult intubation /
- pancreatitis after ERCP

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