摘要
目的探讨低分子右旋糖酐联合吲哚美辛栓剂对内镜逆行胰胆管造影术(ERCP)后胰腺炎的预防作用。方法 215例至少具备一项ERCP术后胰腺炎高危因素的患者术前随机分为四组。对照组(n=51)给予氯化钠注射液+安慰剂,吲哚美辛组(n=54)给予氯化钠注射液+吲哚美辛栓剂(术前单次经直肠给药50 mg),低分子右旋糖酐组(n=52)给予低分子右旋糖酐(术前单次静脉输注500 m L)+安慰剂,药物联用组(n=58)给予低分子右旋糖酐(术前单次静脉输注500 m L)+吲哚美辛栓剂(术前单次经直肠给药50 mg)。观察术后胰腺炎发生率、重症急性胰腺炎发生率及患者死亡率,记录住院时间。结果对照组、吲哚美辛组、低分子右旋糖酐组和药物联用组胰腺炎发生率分别为24%、15%、14%和5%,药物联用组ERCP术后胰腺炎发生率低于对照组(P<0.01);四组患者重症胰腺炎发生率以及死亡率无显著差异(P>0.05)。对照组、吲哚美辛组、低分子右旋糖酐组和药物联用组平均住院时间分别为(5.8±2.9)、(5.2±1.9)、(6.1±2.5)和(4.3±2.0)d,与其他三组相比,药物联用组术后平均住院时间缩短(P<0.05)。结论低分子右旋糖酐联合吲哚美辛栓剂对于ERCP术后胰腺炎有较好的预防作用。
AIM To investigate the preventive rectal indomethacin （Ind） on post ERCP pancreatitis with at least one high risk factor of PEP were randomly effect of low molecular dextran （LMD） combined with （PEP）. METHODS Two hundred and fifteen patients divided into four groups before undergoing ERCP. Fifty-one patients in control group were given sodium chloride injection and placebo. Fifty-four patients in Ind group were given sodium chloride injection and Ind 50 mg by rectum preoperatively. Fifty-two patients in LMD group were given LMD 500 mL by intravenous preoperatively and placebo. Fifty-eight patients in combination treatment group were given LMD 500 mL by intravenous and Ind 50 mg by rectum preoperatively. The main outcome measures were incidence of PEP, incidence of severe acute pancreatitis, incidence of death and length of stay. RESULTS The incidence rate of PEP was 24% , 15% , 14% , and 5% in the control, Ind, LMD and combination treatment group respectively. The incidence of PEP in the combination treatment group was significantly lower than that in the control group （P 〈 0.01）. The incidence of severe acute pancreatitis and mortality did not show difference among the four groups （P 〉 0.05）. Average length of stay was （5.8 ± 2.9）, （5.2 ±1.9）, （6.1 ± 2.5） and （4.3 ± 2.0） d in the control, Ind, LMD and combination treatment group. The average length of stay was shorter in the combination treatment group compared with those in the other three groups （P 〈 0.05）. CONCLUSION LMD combined with rectal Ind has better preventive effect on PEP.
出处
《中国新药与临床杂志》
CSCD
北大核心
2017年第8期484-488,共5页
Chinese Journal of New Drugs and Clinical Remedies
关键词
低分子右旋糖酐
吲哚美辛
胰胆管造影术
内窥镜逆行
胰腺炎
low molecular dextran
indomethacin
cholangiopancreatography, endoscopic retrograde
pancreatitis
