大黄浸泡液联合吲哚美辛栓预防ERCP术后胰腺炎的前瞻性、随机对照研究

Prospective and randomized controlled Rhubarb Soaking Solution combined with Indomethacin Suppository in preventing pancreatitis after ERCP

目的探讨大黄浸泡液联合吲哚美辛栓在预防内镜下逆行胰胆管造影(ERCP)术后胰腺炎(PEP)中的应用价值。方法选取2019年1月至2021年1月于江西省萍乡市人民医院收治的行ERCP术患者160例作为研究对象,采用随机数字表法将其分为对照组和研究组,各80例。对照组采用常规治疗联合术前30 min吲哚美辛栓治疗,研究组采用常规治疗联合术前30 min吲哚美辛栓及术后大黄浸泡液口服。比较两组患者腹痛程度、实验室检查指标、康复效果、PEP及高淀粉酶血症发生率。结果研究组患者的腹痛程度低于对照组,差异有统计学意义(P<0.05)。两组患者治疗前的谷丙转氨酸(ALT)、血清总胆红素(TBil)、C-反应蛋白(CRP)、血清淀粉酶(AMS)水平比较,差异无统计学意义(P>0.05)。研究组患者治疗后的ALT、TBil、CRP、AMS水平低于对照组,差异有统计学意义(P<0.05)。研究组患者的肛门通气、通便、恶心呕吐消失及住院时间短于对照组,异有统计学意义(P<0.05)。研究组患者的PEP、高淀粉酶血症发生率低于对照组,差异有统计学意义(P<0.05)。结论大黄浸泡液联合吲哚美辛栓能够有效预防PEP的发生,缓解腹痛,保护肝功能,降低AMS水平,促进术后恢复。

Objective To explore the application value of Rhubarb Soaking Solution combined with Indomethacin Suppository in the prevention of pancreatitis(PEP)after endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 160 patients undergoing ERCP who were admitted to the Jiangxi Pingxiang People′s Hospital from January 2019 to January 2021 were selected as the research subjects,the random number table was used to divide them into a control group and a study group with 80 cases each.Patients in the control group received conventional treatment combined with Indomethacin Suppository 30 min before operation,and in the study group,patients received conventional treatment combined with Indomethacin Suppository 30 min before operation and Rhubarb Soaking Solution in oral administration after surgery.The degree of abdominal pain,laboratory examination indexes,rehabilitation effect,PEP and the incidence of hyperamylaseemia were compared between the two groups.Results The degree of abdominal pain in the study group was milder than that in the control group,and the difference was statistically significant(P<0.05).There were no significant difference in alanine aminotransferase(ALT),serum total bilirubin(TBil),and C-reaction before(CRP),or serum amylase(AMS)level before treatment in the two groups(P>0.05).The ALT,TBil,CRP,and AMS levels of patients in the study group after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).In the study group,the time of anal exhaust,defecation,and nausea and vomiting disappearing,and hospital stay were shorter than the control group,and the differences were statistically significant(P<0.05).The incidence of PEP and hyperamylaseemia in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Rhubarb Soaking Solution combined with Indomethacin Suppository can effectively prevent the occurrence of PEP,relieve abdominal pain,protect liver function,reduce AMS level,and promote postoperative recovery.