吲哚美辛栓不同时间纳肛预防经内镜逆行胰胆管造影术后胰腺炎的效果分析

Efficacy of rectal indometacin suppositories at different occasions on prevention of pancreatitis after endoscopic retrograde cholangiopancreatography

目的:对比吲哚美辛栓不同时间纳肛预防患者内镜下逆行胰胆管造影(ERCP)术后发生胰腺炎的临床效果。方法:分析2013年5月至2016年11月在安徽医科大学附属六安医院消化内科行ERCP术治疗的患者231例,随机分为术前组124例(术前30min用吲哚美辛栓纳肛),术后组56例(术后30min用吲哚美辛栓纳肛),对照组51例(未用吲哚美辛栓纳肛)。比较3组患者ERCP术后3、24h血清淀粉酶水平,以及术后胰腺炎、高淀粉酶血症的发生率。结果:术前组的术后3、24h血淀粉酶水平均低于术后组,差异有统计学意义(P<0.05);对照组胰腺炎发生率均高于术前组及术后组,术后组胰腺炎发生率均高于术前组,差异有统计学意义(P<0.05)。结论:术前用吲哚美辛栓纳肛预防ERCP术后患者发生胰腺炎的临床效果显著,优于术后用药及未用药。

Objective To compare the clinical effect of indomethacin suppository on preventing pancreatitis after endoscopic retrograde cholangio-pancreatography （ERCP）.Methods Totally 231 patients in the Department of Gastroenterology, Luan Affiliated Hospital of Anhui Medical University, from May 2013 to November 2016, were retrospective analyzed, and randomly divided into preoperative group of 124 cases （30 min before operation with indomethacin suppositories anus）, postoperative group of 56 cases （30 min after operation with indomethacin suppositories anus）, and control group of 51 cases （no indomethacin）. The serum levels of amylase at 3h and 24h after ERCP, and the incidence of post-ERCP pancreatitis（PEP） and hyperamylasemia was compared among the 3 groups.Results The levels of serum amylase at 3h and 24h after operation in the preoperative group were significantly lower than those in the postoperative group（ P〈0.05）. The incidence of PEP in the control group was higher than that in the preoperative and post operative group. The incidence of PEP in postoperative group were higher than those in preoperative group （ P〈0.05）. Conclusion The clinical prevention effect of pre-procedural rectal indometacin suppository on PEP was significantly better than the postoperative group and control group.