血淀粉酶在生长抑素与硫酸镁辅助ERCP治疗急性胰腺炎前后的表达变化及意义

Expression and Significance of Serum Amylase in the Treatment of Acute Pancreatitis in ERCP with Somatostatin and Magnesium Sulfate

目的探讨血淀粉酶在生长抑素与硫酸镁辅助ERCP治疗急性胰腺炎(AP)前后的表达变化及意义。方法选取2016年1月至2017年1月期间,本院经ERCP术诊治的急性胰腺炎患者120例随机分为3组,每组40例。对照组术前30min静脉滴注0.9%氯化钠1000 m L;治疗一组,术中经十二指肠镜注入33%硫酸镁100m L至十二指肠,术后血淀粉酶升高给予0.9%氯化钠1000 m L+生长抑素6mg;治疗二组术前30 min静脉滴注0.9%氯化钠1000 m L+生长抑素6mg,术中经十二指肠镜注入33%硫酸镁100m L至十二指肠。于术前2h,术后2、12、24 h检测3组患者血清淀粉酶水平,同时观察3组的疗效以及临床症状缓解情况。结果患者术前血淀粉酶的水平、及患者主要临床症状无统计学差异(P>0.05)。与对照组相比,两组治疗组术后血淀粉酶水平明显降低,临床症状明显缓解(P<0.05)。与治疗一组相比,治疗二组的血淀粉酶水平显著降低,临床症状明显缓解(P<0.05)。结论生长抑素联合硫酸镁辅助ERCP治疗,能有效缓解急性胰腺炎(AP)的临床症状,并降低血淀粉酶的水平。不同时期给予生长抑素对患者的临床症状及血淀粉酶的水平有显著影响。

Objective To investigate the expression and significance of serum amylase in the treatment of acute pancreatitis in ERCP with somatostatin and magnesium sulfate.Methods From January 2016 to January 2017, 120 patients with acute pancreatitis diagnosed by ERCP were randomly divided into three groups （40 cases each）.In the control group, 0.9% sodium chloride （1000 mL） was infused intravenously 30 min before operation.In one group treated with duodenoscopy, 33% magnesium sulfate （100%） was injected into the duodenum, and 0.9% sodium chloride （1000 mL） and somatostatin （6 mg） were given once the blood amylase elevated.In the treatment group, 0.9% sodium chloride （1000 mL） and somatostatin （6 mg） were infused intravenously at 30 min before operation, and 33% magnesium sulfate （100 mL） was injected into the duodenum through duodenoscope.Serum amylase levels were measured at 2h before, and 2h, 12h, and 24 h after operation postoperatively.At the same time, the effect of the three groups and the clinical symptom relief were observed.Results There was no significant difference in the level of serum amylase and the main clinical symptoms （P〉0.05）.Compared with the control group, the levels of serum amylase were significantly decreased and the clinical symptoms were relieved （P〈0.05） in the two groups.Compared with the treatment group, the levels of serum amylase in the two groups were significantly decreased, and the clinical symptoms were relieved significantly（P〈0.05）.Conclusion Somatostatin combined with magnesium sulfate as adjuvant ERCP can relieve the clinical symptoms of acute pancreatitis （AP） and reduce the content of serum amylase.The effect of somatostatin on the clinical symptoms and serum amylase content of patients is significantly different.