硝酸甘油联合双氯芬酸钠预防ERCP术后急性胰腺炎的研究

Effect of Nitroglycerin Combined with Diclofenac Sodium in the Prevent of Acute Pancreatitis after ERCP

目的:研究硝酸甘油联合双氯芬酸钠预防经内镜逆行胰胆管造影(ERCP)术后急性胰腺炎的效果。方法:选取2019年9月-2021年9月景德镇市第一人民医院消化内科收治的拟行60例ERCP术的患者,应用随机数字表法将患者分为对照组和联合组,每组30例。对照组于ERCP术前给予双氯芬酸钠预防治疗,联合组于ERCP术前给予硝酸甘油联合双氯芬酸钠预防治疗。比较两组术前和术后3、24 h的血常规、血清总淀粉酶及胰淀粉酶水平;比较两组术后急性胰腺炎、高淀粉酶血症发生率和不良反应发生情况。结果:术后3、24 h,联合组白细胞、中性粒细胞、C反应蛋白、血清总淀粉酶及胰淀粉酶水平均低于对照组(P<0.05)。联合组术后急性胰腺炎、高淀粉酶血症发生率均低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:硝酸甘油联合双氯芬酸钠可有效降低ERCP术后急性胰腺炎发生风险,增强预防效果。

Objective:To study the effect of Nitroglycerin combined with Diclofenac Sodium in the prevent of acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).Method:A total of 60 patients who planned to undergo ERCP in Department of Gastroenterology,Jingdezhen NO.1 People’s Hospital from September 2019 to September 2021 were selected,they were divided into control group and combined group according to random number table method,with 30 cases in each group.The control group was given Diclofenac Sodium prophylaxis before ERCP,and the combined group was given Nitroglycerin combined with Diclofenac Sodium prophylaxis before ERCP.The blood routine,serum total amylase and pancreatic amylase levels were compared between the two groups before operation and 3 and 24 h after operation;the incidence of acute pancreatitis,hyperamylasemia and adverse reactions were compared between the two groups.Result:At 3 and 24 h after operation,the levels of leukocyte,neutrophil,C reactive protein,serum total amylase and pancreatic amylase in the combined group were lower than those in the control group (P<0.05).The incidence of acute pancreatitis and hyperamylasemia in the combined group were lower than those in the control group (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:Nitroglycerin combined with Diclofenac Sodium can effectively reduce the risk of acute pancreatitis after ERCP and enhance the preventive effect.