ENBD对预防ERCP术后胰腺炎及高淀粉酶血症的临床效果

Clinical efficacy of ENBD in preventing post-ERCP pancreatitis and hyperamylasemia

目的探讨内镜下鼻胆管引流术(ENBD)对预防内镜下逆行胰胆管造影术(ERCP)后并发胰腺炎和高淀粉酶血症的临床效果。方法需行ERCP治疗患者94例分为两组,分别采用ENBD(观察组,46例)和未行ENBD(对照组,48例)。比较两组患者术后2、12及24 h血清淀粉酶值,观察两组ERCP术后24 h血清相关炎症指标值及高淀粉酶血症、胰腺炎等并发症的发生情况。结果两组ERCP术前血清淀粉酶值比较无统计学差异(P>0.05)。观察组术后2、12及24 h血清淀粉酶值均低于对照组(P<0.01)。两组术前炎症指标WBC、IL-6、CRP及降钙素原(PCT)值比较无统计学差异(P>0.05);观察组患者术后2、12及24 h的WBC、IL-6、CRP及PCT值均低于对照组(P<0.01)。观察组ERCP术后胰腺炎及高淀粉酶血症发生率低于对照组(P<0.05);两组其余相关并发症发生情况相仿(P>0.05)。结论采用ENBD能有效预防ERCP患者术后高淀粉酶血症及胰腺炎的发生。

Objective To observe the clinical efficacy of endoscopic nasobiliary drainage(ENBD)in preventing pancreatitis and hyperamylasemia after endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 92 patients undergoing ERCP was divided into two groups of A(using ENBD,46 cases)and B(without ENBD,48 cases).Serum amylase of two groups was detected at 2,12 and 24 hours after operation.Serum levels of inflammatory indicators at 24 hours after operation and the relevant complications were compared between the two groups.Results There was no significant difference in serum amylase level between the two groups before operation(P>0.05).Serum levels of amylase in group A were lower than those in group B at 2,12 and 24 hours after operation(P<0.01).There were no statistical differences in preoperative inflammatory markers WBC,CRP,IL-6 and PCT between the two groups(P>0.05),which at 2,12 and 24 hours after operation were lower in group A than those in group B(P<0.01).The incidences of pancreatitis and hyperamylasemia in group A were significantly lower than those in group B(P<0.05).The incidences of other relevant complications of two groups were similar(P>0.05).Conclusion ENBD is effective in the prevention of pancreatitis and hyperamylasemia in the patients after ERCP.