吲哚美辛不同给药时间对食管癌ERCP术后并发症的防治效果

Preventive and therapeutic effects of different administration times of indomethacin on postoperative complications of esophageal cancer ERCP

目的观察吲哚美辛不同给药时间对食管癌内镜逆行性胰胆管造影术(ERCP)术后并发症的影响。方法选取行ERCP术的107例食管癌患者,按照随机数字表法分为对照组53例和观察组54例。对照组术后2 h内经直肠注入吲哚美辛配合治疗,观察组术前预先经直肠注入吲哚美辛配合治疗。比较两组术后并发症发生情况,术前、术后的血清淀粉酶(AMS)水平,炎症反应及预后情况。结果观察组的术后并发症发生率和术后6 h、12 h、24 h的AMS水平均低于对照组,差异有统计学意义(P<0.05);术后1 d,观察组IL-6、CRP、TNF-α均低于对照组,(P<0.05);观察组的中位无进展生存期(PFS)、中位总生存期(OS)均高于对照组,病死率低于对照组(P<0.05)。结论术前预先经直肠注入吲哚美辛配合ERCP治疗,能降低食管癌术后并发症发生风险,对抑制各类炎性指标水平并改善患者预后均有积极意义。

Objective To observe the effect of different administration times of indomethacin on postoperative complications of endoscopic retrograde cholangiopancreatography(ERCP)for esophageal cancer.Methods 107 esophageal cancer patients who underwent ERCP were randomly divided into two groups using a number table method.The control group consisted of 53 patients who were received rectal injection of indomethacin for treatment within 2 h after surgery.The observation group consisted of 54 patients who were received preoperative rectal injection of indomethacin for treatment.The postoperative complications,serum amylase(AMS)levels,inflammatory reactions,and prognosis of the two groups of patients were compared.Results The incidence of postoperative complications and AMS levels at 6 h,12 h,and 24 h after surgery in the observation group were lower than those in the control group,and difference was statistically significant(P<0.05);1 d after surgery,IL-6,CRP,TNF-αin the observation group were lower than the control group(P<0.05);the median progression-free surrival(PFS)and median overall surrival(OS)of the observation group were higher than those of the control group,and the mortality rate was lower than that of the control group(P<0.05).Conclusion Preoperative rectal injection of indomethacin combined with ERCP treatment can reduce the risk of postoperative complications in esophageal cancer,inhibit the levels of various inflammatory indicators,and improve patient prognosis,which has a positive significance.