经内镜逆行性胰胆管造影术后应用乌司他丁及心理干预预防胰腺炎的疗效观察

Effect of ulinastatin and psychological intervention on prevention of pancreatitis after endoscopic retrograde cholangiopancreatography

目的观察经内镜逆行性胰胆管造影术（ERCP）后应用乌司他丁及心理干预预防胰腺炎的疗效。方法选取宝鸡市中心医院2015年1月～2016年8月收治的50例进行ERCP手术的胆道疾病患者为研究对象，随机分为对照组和实验组各25例。对照组术后给予乌司他丁治疗，实验组在此基础上给予心理干预，密切关注患者的心理状态变化，积极与患者进行交流和沟通，进行针对性的心理疏导建议，消除负面情绪。比较分析2组患者的抑郁评分（SAS）、焦虑评分（SDS）、胰腺炎发生率、尿淀粉酶恢复正常天数等临床指标。结果治疗前，实验组患者SAS与SDS评分分别为（45.20±4.32）与（46.98±4.88），与对照组相比，差异无统计学意义。治疗后，实验组SAS与SDS评分分别为（27.20±4.12）与（30.12±3.88），显著优于对照组，差异具有统计学意义（P＜0.05）。实验组尿淀粉酶恢复至正常天数为（1.78±0.32）d，显著少于对照组的（2.15±0.92）d，差异具有统计学意义（P＜0.05）。对照组胰腺炎发生率为16.0%，显著高于实验组的4.0%，差异具有统计学意义（P＜0.05）。结论ERCP术后应用乌司他丁及心理干预预防胰腺炎的临床疗效理想，可显著改善患者负面情绪，改善相关临床症状。

Objective To study and analyze the effect of ulinastatin and psychological intervention on prevention of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).Methods50patients with biliary tract diseases who underwent ERCP surgery in Center Hospital in Baoji City from January2015to August2016were selected as the research objects.They were randomly divided into control group and experimental group with25cases in each group.The control group was given Ulinastatin treatment,experimental group on the basis of this treated with psychological intervention,pay close attention to the patient's mental status changes,communicate actively with the patients for psychological counseling advice,eliminate negative emotions,improve the therapeutic effect.The clinical indicators such as depression score(SAS),anxiety score(SDS),occurrence of pancreatitis and the days of normal recovery of urinary amylase were compared and analyzed between the experimental group and the control group.Results Before treatment,the SAS and SDS scores of the experimental group were(45.20±4.32)and(46.98±4.88),there was no significant difference compared with the control group.After treatment,the SAS and SDS scores of the experimental group were(27.20±4.12)and(30.12±3.88),which were significantly better than those of the control group,with statistical significance(P<0.05).In the experimental group,the urine amylase returned to normal days was(1.78±0.32)days,significantly less than the control group was(2.15±0.92)days,with statistical significance(P<0.05).The probability of pancreatitis in the control group was16%,which was significantly higher than that in the experimental group(4%),and the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of ulinastatin and psychological intervention in the prevention of pancreatitis after ERCP is ideal,which can significantly improve the negative emotions of patients and improve the clinical symptoms.