不同时段静脉滴注乌司他丁预防ERCP术后胰腺炎效果分析

Effect of intravenous Ulinastatin at different time to prevent post-ERCP pancreatitis

目的探讨不同给药时间静脉滴注不同剂量乌司他丁对预防ERCP术后胰腺炎的效果。方法选取88例行ERCP术的患者,平均分为4组,分别在术前3 d、术前1 d及术中给予45万U和15万U乌司他丁静脉滴注,观察4组患者术后阳性率、尿淀粉酶恢复正常天数及术后淀粉酶水平。结果术前3 d组ERCP术后患者血液中TNF-α、IL-6与CRP含量明显低于其他3组(P<0.05);其他3组ERCP术后血液中三项指标含量比较差异无统计学意义(P>0.05)。术前3 d组及术中45万组患者术后阳性率、尿淀粉酶恢复正常天数低于术前1 d组及术中15万U组患者(P<0.05);术前3 d组与术中45万U组相比差异无统计学意义(P>0.05)。术前3 d组及术中45万组患者术后1 d尿淀粉酶值明显低于术前1 d组及术中15万U组患者(P<0.05);术前3 d组与术中45万U组尿淀粉酶值差异无统计学意义(P>0.05);术后2 d及3 d 4组之间尿淀粉酶值差异无统计学意义(P>0.05)。结论术前3 d应用15万U乌司他丁乌司他丁预防ERCP术后胰腺炎效果最佳。

Objective To investigate the effect of different doses Ulinastatin at different time to prevent post-operative ERCP pancreatitis.Methods A total of 88 patients who would operate on ERCP were divided into four groups.Ulinastatin were given for three days before surgery and the day before surgery and during surgery,respectively.The positive rates during surgery and urine amylase levels of four groups were observed.Results The TNF-α,IL-6 and CRP levels of patients who applicated 150 000 U Ulinastatin for three days before surgery were significantly lower than those in the other groups （P ＜ 0.05） ; while there was no statistical significance among the other three groups （P ＞ 0.05）.The positive rates and the days of urine amylase that returned to normal in patients who applicated 150 000 U Ulinastatin for three days before surgery and 450 000 U ulinastatin during surgery were significantly lower than those the day before surgery and those in patients who applicated 150 000 U Ulinastatin during surgery （P ＜0.05） ; while there was no statistical significance between the patients who applicated 150 000 U Ulinastatin for three days before surgery and 450 000 U ulinastatin during surgery （P ＞ 0.05）.The Urine amylase level of patients who applicated 150 000 U Ulinastatin for three days before surgery and 450 000 U Ulinastatin during surgery were significantly lower than the day before surgery and 150 000 U Ulinastatin during surgery （P ＜ 0.05） ; while there was no statistical significance between the patients who applicated 150 000 U Ulinastatin for three days before surgery and 450 000 U Ulinastatin during surgery （P ＞0.05）.Also difference of four groups had no statistical significance for two and three days after the surgery.Conclusion The best effect that prevent post-ERCP pancreatitis is to apply 150 000 U Ulinastatin for three days before surgery.