非甾体类抗炎药预防经内镜逆行胰胆管造影术后胰腺炎的研究进展

Application of non-steroidal anti-inflammatory drugs in prevention of pancreatitis after endoscopic retrograde cholangiopancreatography

经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)是目前临床上诊治胆胰疾病的重要方法之一.胰胆管造影术后胰腺炎(post-Endoscopic retrograde cholangiopancreatography pancreatitis,PEP)是其最常见的并发症.非甾体类抗炎药(non-steroidal anti-inflammatory drugs,NSAIDs)作为临床预防PEP的常用药物,其应用标准尚不统一.本文综述了NSAIDs不同的药物类型、给药途径、给药时机、给药剂量、联合其它药物以及对不同风险分层人群的PEP预防效果的研究进展,并指出NSAIDs中的吲哚美辛与双氯芬酸是目前最常使用的药物类型,应常规在术前对所有无禁忌症、未选择患者直肠给药100 mg预防PEP的发生.

Endoscopic retrograde cholangiopancreatography(ERCP)is one of the most important methods for the clinical diagnosis and treatment of biliary and pancreatic diseases.Post-ERCP pancreatitis(PEP)is the most common complication.Non-steroidal anti-inflammatory drugs(NSAIDs)are commonly used in clinical prevention of PEP,but the application standards are not unified.This article reviews the progress in the research of the preventive effect of different types of NSAIDs on PEP,their administration routes,timing,and dosage,and combination with other drugs,as well as the preventive effect of NSAIDs in different risk stratification populations,and points out that indomethacin and diclofenac are the most commonly used types of NSAIDs,which should be given at 100 mg via rectal administration before ERCP in all non-selected patients with no contraindications.