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吲哚美辛联合头孢他啶预防胆总管结石患者ERCP术后胰腺炎的临床研究

Clinical study of indomethacin combined with ceftazidime in the prevention of postoperative pancreatitis in patients with choledocholithiasis after endoscopic retrograde cholangiopancreatography
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摘要 目的探讨吲哚美辛联合头孢他啶对胆总管结石患者内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术后胰腺炎的预防效果。方法选取安徽省阜阳市人民医院2020年3月-2021年12月收治的128例胆总管结石ERCP术后胰腺炎患者,随机数分为研究组和对照组,各64例。对照组采用头孢他啶治疗;研究组在对照组基础上采用吲哚美辛治疗。对比2组手术时间、术中胃蠕动次数;临床症状、改善时间;术前后患者血清淀粉酶(amylase,AMS)、白细胞(white blood cell,WBC)及胃肠功能恢复、术后胰腺炎情况。结果2组手术时间、术中胃蠕动次数比较,差异有统计学意义(P<0.05);治疗后,与对照组相比,研究组的血淀粉酶恢复时间和住院时间均较短(P<0.05);术后,2组AMS、WBC水平均降低,且研究组较对照组更低(P<0.05);研究组术后首次进食时间、术后肛门首次排气时间以及术后首次排便时间均比对照组短(P<0.05);研究组术后胰腺炎总发生率低于对照组(P<0.05)。结论吲哚美辛联合头孢他啶可以改善胆总管结石患者围术期指标,降低AMS、WBC,促进胃肠功能恢复,降低术后胰腺炎发生率,且安全。 Objective To explore the preventive effect of indomethacin combined with ceftazidime on postoperative pancreatitis in patients with choledocholithiasis after endoscopic retrograde cholangiopancreatography(ERCP).Methods A total of 128 patients with choledocholithiasis who developed pancreatitis after ERCP and were admitted to Fuyang People's Hospital in Anhui Province from March 2020 to December 2021 were selected and randomly divided into the study group and the control group according to random number table method,with 64 cases in each group.The control group received ceftazidime treatment;The study group received indomethacin treatment on the basis of the treatment of the control group.The operation time,the number of gastric peristalsis during the operation,the improvement time of clinical symptoms,preoperative and postoperative serum amylase(AMS)and white blood cells(WBC)levels,the recovery of gastrointestinal function,and postoperative pancreatitis were compared between two groups.Results There were statistically significant differences in the operation time and the number of gastric peristalsis during the operation between two groups(P<0.05).After treatment,the recovery time of serum AMS levels and hospitalization time of the study group were shorter than those of the control group(P<0.05).After surgery,the levels of AMS and WBC in both groups decreased,and the study group was lower than the control group(P<0.05).The first postoperative feeding time,the first postoperative anal exhaust time and the first postoperative defecation time of the study group were shorter than those of the control group(P<0.05).The total incidence of postoperative pancreatitis in the study group was lower than that in the control group(P<0.05).Conclusion Indomethacin combined with ceftazidime can improve perioperative indexes in patients with choledocholithiasis,reduce AMS and WBC levels,promote gastrointestinal function recovery,and reduce the incidence of postoperative pancreatitis.This therapy is safe.
作者 韩曼曼 王桂周 代子艳 HAN Manman;WANG Guizhou;DAI Ziyan(Department of Gastroenterology,Fuyang People's Hospital,Fuyang 236000,China)
出处 《长春中医药大学学报》 2024年第5期552-555,共4页 Journal of Changchun University of Chinese Medicine
基金 安徽省自然科学基金项目(2019B00185)。
关键词 吲哚美辛 内镜逆行胰胆管造影 头孢他啶 首次排气时间 胆总管结石 胰腺炎 indomethacin endoscopic retrograde cholangiopancreatography ceftazidime first exhaust time choledocholithiasis pancreatitis
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