奥曲肽对ERCP术后高淀粉酶血症及胰腺炎的预防疗效

Preventive effect of octreotide on the hyperamylasemia and pancretitis after ERCP

目的探讨奥曲肽对内镜逆行胆胰管造影(ERCP)术后高淀粉酶血症及胰腺炎的预防作用。方法行ERCP患者40例,随机分为两组:预防组20例,于术前1h静滴奥曲肽0.3mg+5%葡萄糖液500ml,停止输注后6h和12h分别给予奥曲肽0.1mg皮下注射各1次。对照组20例,术前1h开始静脉滴注0.9%生理盐水500ml,既不使用奥曲肽治疗也不皮下注射生理盐水,并分别于术前、术后2、12及24h作血清淀粉酶测定,同时观察胰腺炎的发生情况。结果预防组术后2、12及24h的血清淀粉酶(U/L)分别为(182.0±128.9)、(160.9±107.4)及(119.2±76.6),低于对照组水平(195.5±140.8)、(243.8±292.5)和(172.0±251.0),但未达统计学意义。预防组未出现急性胰腺炎,对照组发生2例术后急性胰腺炎(P<0.05)。结论奥曲肽可预防ERCP术后急性胰腺炎的发生。

Objective To study the preventive effect of octreotide on the hyperamylasemla and pancretitis after ERCP （endoscopic retrograde cholangiopancreatography, ERCP）. Methods 40 patients were randomly divided into 2 groups. One concluded 20 cases which were applied with octreotide 0.3mg ＋ 5% GS 500ml an hour before ERCP. 6 hours and 12hours after that, 0. ling octreotide would separately be applied again hypodermically . The other group also concluded 20 cases, which were given 0.9% NS 500ml an hour before ERCP. And this group was neither applied with octreotide nor NS hypodemically. The mean concentration of serum amylase before ERCP and 2h, 12h,24h after ERCP was measured in all patients. And the abdominal pain and pancreatitis after ERCP were also abserved . Results The mean concentration of serum amylase at 2h, 12h, 24h after ERCP were （ 182.0±128.9）U/L, （160.9±107.4）U/L and （119.2 ±76.6）U/L in preventive group, and （ 195.5±140.8） U/L, （243.8±292.5） U/L, （ 172.0±251.0）U/L in control group （ P 〉 0.05） .There was no post - ERCP pancreatitis in preventive group, but 2 cases of post - ERCP pancreatitis in control group. Conclusions Prophylactic treatment with octreotide reduces the incidence of post - ERCP pancreatitis.