摘要
目的探讨生长抑素和硝酸甘油对经内镜逆行胰胆管造影术（ERCP）术后胰腺炎（PEP）及高淀粉酶血症的预防效果。方法184例ERCP诊疗患者按随机数字表法随机分入3组，ERCP术后分别给予生长抑素（生长抑素组）、硝酸甘油（硝酸甘油组）、生理盐水（安慰剂组）静脉内持续泵注12h，观察ERCP术后高淀粉酶血症和PEP发生率并行对比分析。结果9例给予硝酸甘油后发生不良反应，停药并退出本次研究。ERCP术后高淀粉酶血症发生率生长抑素组、硝酸甘油组、安慰剂组分别为38．7％（24／62）、51．8％（28／54）和37．3％（22／59），各组间差异均无统计学意义（P〉0．05）。PEP发生率生长抑素组、硝酸甘油组、安慰剂组分别为6．4％（4／62）、9．3％（5／54）和23．7％（14／59），生长抑素组（x2=7．13，P=0．01）和硝酸甘油组（x2=4．22，P=0．03）均明显低于安慰剂组，差异均有统计学意义，但生长抑素组与硝酸甘油组比较差异无统计学意义（x2=0．32，P=0．41）。结论ERCP术后静脉给予生长抑素或硝酸甘油均能有效预防PEP的发生，效果大致相同，且前者安全性好于后者，但两者对ERCP术后高淀粉酶血症均无明显预防作用。
Objective To investigate the preventive effect of somatostatin and nitroglycerin on post- ERCP pancreatitis （PEP） and hyperamylasemia. Methods A total of 184 patients who underwent endo- scopic retrograde cholangiopancreatograph （ERCP） were enrolled, and randomly divided into three groups to receive somatostatin or nitroglycerin or normal saline according to random number table. Incidence of PEP and hyperamylasemia were observed and compared among the three groups. Results Nine patients stopped the medication and dropped out of the study after occurence of adverse reactions from receiving nitroglycerin injections. The incidence rates of hyperamylasemia were 38. 7% （24/62）, 51.8% （28/54） and 37.3% （22/59） in somatostatin, nitroglycerin and control group respectively, with no significant differences among the three groups （P 〉0. 05）. The incidence rates of PEP were 6, 4% （4/62）, 9. 3% （5/54） and 23.7% （14/59） in somatostatin, nitroglycerin and control group, respectively. The incidence rates of PEP in soma- tostatin and nitroglycerin group were both significantly lower than that in control group （ somatostatin group vs control group..）（2 =7. 13 ,P =0. 01 ; nitroglycerin group vs control group..）（~ =4. 22,P =0. 03）. There was no significant difference between somatostatin group and nitroglycerin group （X2 --0, 32, P = 0.41 ）. Conclusion Somatostatin and nitroglycerin injections after ERCP show similar efficacy on preventing PEP, but the for- mer is safer. Both have little effects on the prophylaxis of hyperamylaemia.
出处
《中华消化内镜杂志》
2014年第4期206-209,共4页
Chinese Journal of Digestive Endoscopy
关键词
胰胆管造影术
内窥镜逆行
胰腺炎
高淀粉酶血症
生长抑素
硝酸甘油
Cholangiopancreatography, endoscopic retrograde
Pancreatitis
Hyperamylasemia
Somatostatin
Nitroglycerin
