善宁对内镜逆行性胰胆管造影术后胰腺炎及高淀粉酶血症的临床干预评价

Clinical evaluation on Sandostatin′s (octreotide) intervention in post- ERCP pancreatitis and hyperamylasemia

目的探讨善宁对内镜逆行性胰胆管造影(ERCP)术后胰腺炎及高淀粉酶血症的防治作用。方法接受ERCP且术前血淀粉酶在正常范围内的患者随机分为三组,分别为术前干预组、术后干预组、空白对照组。术前干预组于术前1h给予善宁0.6mg静滴;术后干预组于术后2h给予善宁0.6mg静滴;空白对照组不做处理。三组患者分别于术后3h和24h测定血清淀粉酶及观察术后胰腺炎的发生情况。结果术前干预组术后3h及24h血清淀粉酶值较术后干预组及空白对照组低,且差异具有统计学意义(P<0.05)。术后干预组术后3h及24h血清淀粉酶值较空白对照组低,且差异具有统计学意义(P<0.05)。三组患者术后胰腺炎发病率的组间差异无统计学意义(P>0.05)。结论善宁能降低ERCP术后血清淀粉酶数值,但不能减少胰腺炎的发生率。

Objective To study the preventive and therapeutic effect of Sandostatin（ octreotide ） on the pancreatitis and hyperamylasemia after endoscopic retrograde cholangiopancreatography （ ERCP ） ： Methods 225 patients underwent ERCP and the concentration of their serum amylase was within the normal range, including 142 men and 83 women, aged 26 - 85 years old, average 51.4 years old, were randomly divided into three groups ： pre - operation group, post - operation group and control group. Three groups were treated respectively with 0.6 mg Sandostatin iv gtt 1 hour before the operation, 0.6 mg Sandostatin iv gtt 2 hours after the operation and no treatment . The concentration of serum amylase at 3 and 24 h after ERCP was measured in all the patients, and the pancreatitis after ERCP was also observed in all the patients. Results The concentration of serum amylase at 3 and 24 h after ERCP in pre - operation group was significantly lower than that in the post - operation group and control group （ P 〈 0.05 ）. The concentration of serum amylase at 3 and 24 h after ERCP in post - operation group was significantly lower than that in the control group （ P 〈 0.05 ）. There were no statistical differences in the morbidity of pancreatitis after ERCP among the three groups （ P 〉 0.05 ）. Conclusions Sandostatin treatment before or after the operation can effectively lower serum amylase after ERCP, but can not decrease the morbidity of pancreatitis after ERCP.