双氯芬酸钠栓预防ERCP术后胰腺炎的临床分析

Clinical Analysis of Diclofenac Sodium Suppository in Preventing Pancreatitis after ERCP Operation

目的探析双氯芬酸钠栓预防ERCP术后胰腺炎的临床效果。方法方便选取该院在2014年5月—2017年4月期间收治的180例内镜下逆行胰胆管造影术(ERCP)的患者,将其随机分为研究组和对照组,各为90例,研究组在术前30 min和术后1 h给予患者双氯芬酸钠栓剂,50 mg,塞肛,对照组给予禁食、补液、抑酸等常规治疗,两组均在术前及术后3、12 h及术后24 h检测血清淀粉酶水平,比较两组术后胰腺炎、高淀粉酶血症的发生率及血清淀粉酶水平等。结果研究组血清淀粉酶水平术后3 h(194.7±70.8)U/L、12 h(320.5±100.2)U/L及术后24 h(260.3±78.4)U/L均显著低于对照组(P<0.05);研究组术后胰腺炎的发生率2.22%、高淀粉酶血症20.0%与对照组13.33%、35.56%比较差异有统计学意义(P<0.05)。结论对内镜下逆行胰胆管造影术(ERCP)的患者,给予双氯芬酸钠栓剂预防术后胰腺炎的发生,效果明显,值得临床推广。

Objective This paper tries to study the clinical effect of diclofenac sodium suppository in preventing pancreatitis after ERCP. Methods 180 patients with endoscopic retrograde cholangiopancreatography（ERCP） were enrolled in this hospital from May 2014 to April 2017 and were convenient selected and randomly divided into the study group and the control group. The rats in the control group were treated with diclofenac sodium suppositories, 50 mg, acupuncture and the control group was treated with fasting, rehydration and acid suppression. The serum amylase levels of preoperative and postoperative3 h, 12 h and 24 h were detected, postoperative pancreatitis, the incidence of high amylase and serum amylase levels of the two groups were compared. Results The levels of serum amylase in the study group were significantly lower than those in the control group at 3 h of（194.7 ±70.8）U/L, 12 h of（320.5 ±100.2）U/L and 24 h of（260.3 ±78.4）U/L,（P〈 0.05）. The incidence of pancreatitis was 2.22% in the study group and 20.0% in the high amylase and 13.33% and 35.56% in the control group respectively（P〈0.05）. Conclusion Diclofenac sodium suppositories can prevent the occurrence of postoperative pancreatitis in patients undergoing endoscopic retrograde cholangiopancreatography（ERCP）. The effect is obvious and deserves clinical promotion.