舌下含化硝酸甘油预防ERCP术后急性胰腺炎效果临床研究

CLINICAL STUDY ON THE PREVENTION OF ACUTE PANCREATITIS AFTER ERCP WITH USING NITROGLYCERIN SUBLINGUALLY

目的探讨舌下含化硝酸甘油预防经内镜逆行胰胆管造影术(ERCP)后急性胰腺炎的效果。方法将70例拟施行ERCP的胆总管结石患者随机分为观察组和对照组各30例,观察组术前予硝酸甘油0.5mg舌下含化,对照组不予硝酸甘油,观察两组术前及术后3、24h血清淀粉酶水平,术前、术后24hCRP,ET,IL-6水平。比较两组急性胰腺炎发生情况。结果观察组术后3、24h血清淀粉酶水平及术后24hCRP,ET,IL-6水平均低于对照组,P均<0.05;观察组发生急性胰腺炎1例(3.3%),对照组为5例(16.7%),两组发生率比较P<0.05。结论舌下含化硝酸甘油对预防ERCP术后急性胰腺炎有重要意义。

Objective To evaluate the effect of prophylactic nitroglycerin in the prevention of post-endoscopic retrograde cholangiopancreatography（ERCP）pancreatitis（PEP）.Methods Seventy patients were randomly divided into 2 groups（35 in each group）groups：nitroglycerin group（n=35）,in which 0.5 mg nitroglycerin was given sublingually in 5～10 min before ERCP;control group（ n=35）,in which no nitroglycerin was given.The levels of serum amylase,endotoxin（ET）,CRP and interleukin-6（IL-6）and of all the patients before ERCP and at 3 h,24 h after ERCP were detected and the incidence of hyperamylasemia and PEP were also observed.Results The values of AMS,ET,CRP and IL-6 in control group were significantly higher at 3 h and 24 h after ERCP than those of nitroglycerin group（P〈0.05）PEP（2.8% 1/35）in nitroglycerin group was respectively significantly lower than that in control group（14.2% 5/35）,P〈0.05.Conclusion Sublingual nitroglycerin prevent post-endoscopic retrograde cholangiopancreatography（ERCP）pancreatitis.