消炎痛栓预防胆总管结石ERCP术后胰腺炎的效果

INDOMETACIN SUPPOSITORIES IN THE PREVENTION OF POST-ERCP PANCREATITIS IN PATIENTS WITH COMMON BILE DUCT STONES

目的观察直肠应用消炎痛栓预防胆总管结石病人内镜下逆行胰胆管造影术(ERCP)术后胰腺炎、高淀粉酶血症的效果。方法将符合标准的胆总管结石病人113例随机分为2组,预防组60例,对照组53例。预防组术前1h给予消炎痛栓100mg塞肛,对照组不给予消炎痛栓。测定两组病人术前及术后6、24h血清淀粉酶水平,观察ERCP术后高淀粉酶血症、急性胰腺炎的发生率。结果预防组ERCP术后6、24h血清淀粉酶水平明显低于对照组(t=-2.31、-2.20,P<0.05)。预防组胰腺炎及高淀粉酶血症发生率明显低于对照组(χ2=3.902、5.316,P<0.05)。结论直肠应用消炎痛栓可以预防胆总管结石病人ERCP术后高淀粉酶血症及胰腺炎的发生。

Objective To investigate the prevention of intrarectal use of indometacin suppositories （IS） for post-endo- scopic retrograde cholangiopancreatography （ERCP） hyperamylasemia and pancreatitis. Methods This study enrolled 113 pa- tients met the criteria of common duct stones, who were divided into two groups： 60 in prevention group, and 53 in control group. One hour before ERCP, 100 mg of IS was inserted into anus in patients in prevention group, for those in the control, no IS was of- fered. Serum amylase was detected in both groups before and six and 24 hours after ERCP. The incidence of post ERCP pancreati- tis and hyperamylasemia was observed. Results The serum amylase level in prevention group, six and 24 hours after ERCP, was markedly lower than that in the control （t=- 2.31,-2.20 ;P〈0.05）, and the incidence of pancreatitis and hyperamylasemia was significantly lower （χ^2 = 3. 902,5. 316;P〈0.05）. Conclusion Intrarectal application of IS may prevent post-ERCP pancrea- titis and hyperamylasemia in patients with common duct stones.