鼻胆管引流在内镜逆行胰胆管造影术后胰腺炎的临床研究

Clinical effect of endoscopic nasobiliary drainage on post-ERCP pancreatitis

目的探讨鼻胆管引流对内镜逆行胰胆管造影术后胰腺炎的预防作用。方法将拟行内镜逆行胰胆管造影术的92例患者随机分为对照组和实验组。对照组46例患者术后未行鼻胆管引流,实验组46例患者术后置入鼻胆管引流。分别于术后3 h、12h、24 h及48 h测定患者血淀粉酶,同时观察胰腺炎的临床表现。对比两组患者的血淀粉酶值和胰腺炎的发生率。观察两组血淀粉酶水平恢复时间及临床症状缓解时间。结果两组在性别、年龄、病因及治疗上均无显著差异具有可比性(P>0.05)。实验组胰腺炎发生率为8.69%,轻型6.52%,重型2.17%,显著低于对照组的26.09%、17.39%、8.69%(P<0.05)。实验组术后3 h、12 h及24 h血清淀粉酶水平均低于对照组(P<0.05)。对照组平均住院时间显著高于实验组(P<0.05)。实验组血清淀粉酶水平恢复正常时间与临床症状缓解时间均明显低于对照组(P<0.05)。结论鼻胆管引流能有效地预防内镜逆行胰胆管造影术后胰腺炎的发生。

Objective To study the preventive effect of endoscopic nasobiliary drainage on the pancreatitis after endoscopic retrograde cholangiopancreatography（ERCP）. Methods 92 patients who received endoscopic retrograde cholangiopancreatography were enrolled into two groups randomly：control group and experimental group（nasobiliary drainage after the operation）.Hemodiastase and symptoms were observed 3,12,24 or 48 hours after operation. Results There was no distinct difference between the two groups in sex,age,causes of disease and treatment.The occurrence of pancreatitis of the experimental group was 8.69%（mild 6.52% and severe 2.17%）,which was obviously lower than that of control group.Similiar results were found in hemodiastase.The average time of stay in hospital in control group was obviously longer than that in experimental group.The time of recovering of hemodiastase and symptom relieving were longer in control group compared with experimental group. Conclusion The result suggests that endoscopic nasobiliary drainage may prevent post-ERCP pancreatitis.