加贝酯对ERCP选择性胆管插管的影响

Effects of gabexate on selective bile duct cannulation

目的:探讨加贝酯对内镜下逆行胰胆管造影术(ERCP)治疗胆总管结石的影响。方法:将2010年3月至2012年9月昆山市第一人民医院收治的86例拟行ERCP术的胆总管结石患者按随机双盲原则分为加贝酯组(46例)和对照组(40例)。统计两组ERCP选择性胆管插管成功率、术后高淀粉酶血症和术后胰腺炎发生率。结果:加贝酯组和对照组患者选择性胆管插管成功率、术后胰腺炎发生率分别为93%(43/46)和85%(34/40)、7%(3/46)和12%(5/加),两组比较,差异无统计学意义(P>0.05)。加贝酯组和对照组患者术后高淀粉酶血症发生率分别为17%(8/46)和38%(15/40),两组比较,差异有统计学意义(P<0.05)。结论:ERCP术前使用加贝酯不能提高胆总管结石ERCP选择性胆管插管成功率,也不能减少ERCP术后胰腺炎的发生,但可降低ERCP术后高淀粉酶血症的发生。

Objective：To investigate the effects of gabexate on selective bile duct cannulation via ERCP. Methods： Eighty-six patients with common bile duct calculus scheduled for ERCP in Kunshan First People＇s Hospital between March 2010 and September 2012 were randomized to gabexate group （n =46） or placebo group （n = 40）. This entailed comparison on the success rate of cannulatiou and the incidence of postoperative hyperamylasemia and pancreatitis. Results： The difference in success rate of selective bile duct cannulation （93.48%, 43/46 vs. 85.00% , 34/40） and postoperative incidence of panereatitis （7.00% , 3/46 vs. 12%, 5/40） was unremarkable （both P 〉 0.05 ）. Gabexate group was associated with a markedly lower incidence of hyperamylasemia （37.50% , 8/46 vs. 38.0% , 15/40, P 〈 0.05 ）. Conclusion： Infusion of gabexate prior to ERCP neither increases the success rate of selective bile duct cannulation nor reduces the incidence of post-ERCP pancreatitis vet was associated with reduced incidence of＂ Dost-ERCP hvDeramvlasemia.